Surgical Treatment of Hyperparathyroidism Using the Quick Parathyroid Assay
| Autor: | Todd M. McCarty, John O'Brien, John T. Preskitt, Jeffrey S. Stephens, Joseph A. Kuhn, Stacy L. Stratmann |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Parathyroidectomy
Hyperparathyroidism medicine.medical_specialty Adenoma business.industry medicine.medical_treatment General Medicine 030204 cardiovascular system & hematology Hyperplasia medicine.disease Extent of resection Article Surgery 03 medical and health sciences 0302 clinical medicine medicine 030212 general & internal medicine Surgical treatment business Surgical incision Parathyroid adenoma |
| Zdroj: | Baylor University Medical Center Proceedings. 15:363-365 |
| ISSN: | 1525-3252 0899-8280 |
| DOI: | 10.1080/08998280.2002.11927865 |
| Popis: | The quick intraoperative parathyroid assay (qPTH) has been proposed as an effective tool in the surgical management of hyperparathyroidism. By measuring intact parathyroid hormone intraoperatively, the qPTH assay may facilitate directed exploration for solitary adenomas and may help guide the extent of resection in hyperplasia. In this study, results of the qPTH assay were analyzed prospectively in 63 consecutive patients who underwent exploration for hyperparathyroidism. Blood samples were drawn prior to surgical incision, prior to gland excision, and 5 and 10 minutes after gland excision. A decline >/=50% of the highest preincision or preexcision level within 10 minutes of resection was considered successful. Forty-nine patients (78%) had a solitary parathyroid adenoma. The qPTH assay was successful in 48 (98%) of these patients. One patient showed a delayed decline at 20 minutes. Fourteen patients (22%) had multiglandular disease: 6 with primary hyperplasia, 4 with hyperplasia secondary to renal failure, and 4 with double adenomas. The assay was successful in all of these patients. It detected multiglandular disease in 8 of 14 patients thought preoperatively to have solitary adenoma. Overall, the qPTH assay was successful in 62 of 63 patients (98%). All patients were normocalcemic after a median follow-up interval of 8 months. These data suggest that the qPTH assay can accurately facilitate directed neck exploration for solitary adenomas, guide the extent of resection for hyperplasia, and identify unknown multiglandular disease. It appears to eliminate the most common cause of parathyroidectomy failure, thereby improving surgical success rates while potentially decreasing morbidity, cost, and operative time. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|