PMID- 10598198
OWN - NLM
STAT- MEDLINE
DCOM- 20000104
LR  - 20220318
IS  - 0039-6060 (Print)
IS  - 0039-6060 (Linking)
VI  - 126
IP  - 6
DP  - 1999 Dec
TI  - Initial experience with intraoperative PTH determinations in the surgical 
      management of 130 consecutive cases of primary hyperparathyroidism.
PG  - 1132-7; discussion 1137-8
AB  - BACKGROUND: Successful surgical management of primary hyperparathyroidism (1 
      degree HPT) historically has required bilateral neck exploration. The 
      intraoperative parathyroid hormone (IO-PTH) assay allows a more limited procedure 
      by confirming complete removal of hypersecreting tissue. METHODS: Plasma samples 
      were obtained from 130 consecutive patients both before (preincision and 
      preexcision baselines) and at approximately 5 and 10 minutes (and additional 
      times) after removal of abnormal parathyroid tissue. Samples were assayed for 
      IO-PTH by a rapid, two-site immunochemiluminescent assay (ICMA) with a 7-minute 
      incubation at 45 degrees C. RESULTS: Plasma IO-PTH decreased by at least 50% in 
      126 of 130 cases; however, three of these cases were false positives. The four 
      cases in which IO-PTH fell < 50% were classified as two true negatives and two 
      false negatives. A single adenoma was removed in 125 cases, and two or three 
      hyperplastic glands were removed in five cases. CONCLUSIONS: IO-PTH predicted the 
      postoperative outcome in 125 of 130 cases (96.2%), including two of five cases in 
      which multiple hyperplastic glands were removed, and 1 degree HPT was 
      successfully treated in 97.7% (127/130) of the cases. The IO-PTH procedure can 
      provide valuable confirmation to the endocrine surgeon; however, other sources of 
      information must also be used to ensure that all hyperplastic glands are 
      identified.
FAU - Garner, S C
AU  - Garner SC
AD  - Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
FAU - Leight, G S Jr
AU  - Leight GS Jr
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
RN  - 0 (Parathyroid Hormone)
SB  - IM
MH  - Adenoma/blood/epidemiology/surgery
MH  - Adult
MH  - Aged
MH  - Chemistry, Clinical/standards
MH  - False Negative Reactions
MH  - False Positive Reactions
MH  - Female
MH  - Humans
MH  - Hyperparathyroidism/*blood/epidemiology/*surgery
MH  - Immunoradiometric Assay
MH  - Incidence
MH  - Intraoperative Period
MH  - Male
MH  - Middle Aged
MH  - Parathyroid Hormone/*blood
MH  - Parathyroid Neoplasms/blood/epidemiology/surgery
MH  - *Parathyroidectomy
MH  - Predictive Value of Tests
MH  - Reproducibility of Results
EDAT- 1999/12/22 09:00
MHDA- 2001/03/28 10:01
CRDT- 1999/12/22 09:00
PHST- 1999/12/22 09:00 [pubmed]
PHST- 2001/03/28 10:01 [medline]
PHST- 1999/12/22 09:00 [entrez]
AID - S0039-6060(99)70072-3 [pii]
AID - 10.1067/msy.2099.101429 [doi]
PST - ppublish
SO  - Surgery. 1999 Dec;126(6):1132-7; discussion 1137-8. doi: 10.1067/msy.2099.101429.