Increase in serum parathyroid hormone level intraoperatively after parathyroidectomy for primary hyperparathyroidism.

BACKGROUND

To evaluate the significance of increased of intraoperative parathyroid hormone(IOPTH) 10 min after parathyroidectomy in primary hyperparathyroidism.

METHODS

All patients underwent parathyroidectomy were retrospectively included. Following the results of IOPTH, three groups were defined: Group 1: increased of IOPTH, Group 2: <50 % decreased of IOPTH, and Group 3: >50 % decreased of IOPTH.

RESULTS

Unilateral approach was performed and shifted to bilateral neck exploration(BNE) when indicated. There were single adenoma, double adenomas, and hyperplasia in 84 %, 5 %, and 11 % of cases respectively. We noted that 100 %, 80 %, and 4 % of patients had a polyglandular diseases in Groups 1, 2, and 3 respectively. Double adenoma and hyperplasia were present in 55 %, and 45 %, 22 %, and 58 %, 1 %, and 3 % in Groups 1, 2, and 3 respectively. Female patients represented 55 %, 71 %, and 81 % of patients in Groups 1, 2, and 3 respectively. Cure rate was 99 %.

CONCLUSIONS

Patients with increased of IOPTH level 10 min after parathyroidectomy had a polyglandular diseases in 100 % of cases and needed BNE.