Use of intraoperative parathyroid hormone assay in primary hyperparathyroidism: A selective approach

Autor: Anthony Chi‐chung Shek, Wai‐Keung Chick, Dora Kai-Chun Tai, Philip Lap‐fai Tang
Rok vydání: 2017
Předmět:
Zdroj: Surgical Practice. 21:42-49
ISSN: 1744-1625
DOI: 10.1111/1744-1633.12226
Popis: Background The routine use of intraoperative parathyroid hormone assay (IOPTH) in minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism has been questioned. In this study, we selectively employed IOPTH only to cases which did not show concordant results in Sestamibi Scan, ultrasound, and operative findings. Method 100 patients received MIP with selective use of IOPTH for primary hyperparathyroidism from March 2006 to June 2015 (“Selective IOPTH” group), were compared to a historical cohort of 57 patients who received MIP with mandatory IOPTH between Mar 2002 and Feb 2006 (“Mandatory IOPTH” group). For the Selective IOPTH group, all cases had preoperative Sestamibi Scan and ultrasound performed; where there were concordant results in Sestamibi Scan, ultrasound, and operative findings, IOPTH would not be performed. The surgical cure rate and operative time of the 2 groups were compared. Results We found no significant difference in the surgical cure rate between the “Selective IOPTH” group and the “Mandatory IOPTH” group. (Short term 6 months postoperative cure rate: 99vs.100%, respectively, p = 1.0; long term cure rate: 99.0 vs. 98.2%; p = 1.0 ) However, operative time was significantly shorter in the “Selective IOPTH” group when compared with the “Mandatory IOPTH” group. (64vs.92 min, respectively; p
Databáze: OpenAIRE
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