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Intraoperative monitoring of intact PTH during surgery for primary hyperparathyroidism

Bergenfelz, A LU ; Isaksson, A LU and Ahrén, B LU (1994) In Deutsche Zeitschrift für Chirurgie 379(1). p.3-50
Abstract

The intraoperative differential diagnosis between adenoma and hyperplasia during surgery for primary hyperparathyroidism (pHPT) is sometimes difficult. Several methods have been proposed to aid the surgeon in deciding on the amount of parathyroid tissue to be resected. We examined the use of intraoperative monitoring of intact PTH in 47 patients operated upon for pHPT. The highly sensitive assay for intact PTH was modified to permit a total turn-around time from gland excision to obtained result of about 60 min. The correlation (r) between the results of the modified and the conventional method, which requires 24 h of incubation, was 0.98. At 15 min after removal of the parathyroid adenoma the levels of intact PTH had decreased by [mean... (More)

The intraoperative differential diagnosis between adenoma and hyperplasia during surgery for primary hyperparathyroidism (pHPT) is sometimes difficult. Several methods have been proposed to aid the surgeon in deciding on the amount of parathyroid tissue to be resected. We examined the use of intraoperative monitoring of intact PTH in 47 patients operated upon for pHPT. The highly sensitive assay for intact PTH was modified to permit a total turn-around time from gland excision to obtained result of about 60 min. The correlation (r) between the results of the modified and the conventional method, which requires 24 h of incubation, was 0.98. At 15 min after removal of the parathyroid adenoma the levels of intact PTH had decreased by [mean (SD)] 85 (11)%. A decrease of 63% in intact PTH in patients with parathyroid adenoma predicted with 95% confidence the 4 patients with primary hyperplasia as not having parathyroid adenoma. We conclude that intraoperative measurement of intact PTH could be a valuable adjunct to surgical skill, especially for reoperative parathyroid surgery.

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published
keywords
Adenoma, Aged, Female, Humans, Hyperparathyroidism, Hyperplasia, Male, Middle Aged, Monitoring, Intraoperative, Parathyroid Glands, Parathyroid Hormone, Parathyroid Neoplasms, Journal Article, Research Support, Non-U.S. Gov't
in
Deutsche Zeitschrift für Chirurgie
volume
379
issue
1
pages
4 pages
publisher
Springer
external identifiers
  • scopus:0028087336
ISSN
0023-8236
language
English
LU publication?
yes
id
a5a2e4ab-015e-49ee-b02d-51af80bc8de6
date added to LUP
2017-05-10 17:43:42
date last changed
2017-09-08 16:11:40
@article{a5a2e4ab-015e-49ee-b02d-51af80bc8de6,
  abstract     = {<p>The intraoperative differential diagnosis between adenoma and hyperplasia during surgery for primary hyperparathyroidism (pHPT) is sometimes difficult. Several methods have been proposed to aid the surgeon in deciding on the amount of parathyroid tissue to be resected. We examined the use of intraoperative monitoring of intact PTH in 47 patients operated upon for pHPT. The highly sensitive assay for intact PTH was modified to permit a total turn-around time from gland excision to obtained result of about 60 min. The correlation (r) between the results of the modified and the conventional method, which requires 24 h of incubation, was 0.98. At 15 min after removal of the parathyroid adenoma the levels of intact PTH had decreased by [mean (SD)] 85 (11)%. A decrease of 63% in intact PTH in patients with parathyroid adenoma predicted with 95% confidence the 4 patients with primary hyperplasia as not having parathyroid adenoma. We conclude that intraoperative measurement of intact PTH could be a valuable adjunct to surgical skill, especially for reoperative parathyroid surgery.</p>},
  author       = {Bergenfelz, A and Isaksson, A and Ahrén, B},
  issn         = {0023-8236},
  keyword      = {Adenoma,Aged,Female,Humans,Hyperparathyroidism,Hyperplasia,Male,Middle Aged,Monitoring, Intraoperative,Parathyroid Glands,Parathyroid Hormone,Parathyroid Neoplasms,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {1},
  pages        = {3--50},
  publisher    = {Springer},
  series       = {Deutsche Zeitschrift für Chirurgie},
  title        = {Intraoperative monitoring of intact PTH during surgery for primary hyperparathyroidism},
  volume       = {379},
  year         = {1994},
}