Rapid intraoperative parathyroid hormone assay in the surgical management of hyperparathyroidism.

摘要: Context: Historically, successful surgical management of primary hyperparathyroidism has required bilateral exploration the neck. By confirming complete removal hypersecreting tissue, an intraoperative parathyroid hormone (IO-PTH) assay allows use a more limited procedure. Objective: Our objective was to evaluate utility IO-PTH used in 32 explorations versus conventional before advent assays. Methods: Minimally invasive parathyroidectomy (MIP) used. Plasma samples were obtained at several intervals and analyzed for by rapid immunochemiluminescent (ICMA). Outcomes assessed univariate inferential testing, yielding one-tailed t-test results. Results: The study group had mean plasma level decrease 87% ten minutes after excision. All patients who underwent MIP using monitoring surgery. At last postoperative follow-up examination, all normocalcemic. There statistically significant decreases duration surgery, length hospital stay, surgery cost. Conclusions: levels predicted outcome studied, can provide valuable information surgeons, stay.