Quick parathormone assay in the surgical management of hyperparathyroidism.

BACKGROUND

Among the various new technologies in the field of parathyroid surgery is intraoperative quick parathormone measurements.

OBJECTIVES

To evaluate the contribution of QPTH measurements during parathyroidectomy to the achievement of higher success rates.

METHODS

QPTH assay using Immulite Turbo Intact PTH was measured in 32 patients undergoing parathyroidectomy: 30 for primary and 2 for secondary hyperparathyroidism. QPTH levels were measured at time 0 minutes (before incision) and at 10, 20, and 30 minutes after excision of the hyperfunctioning gland. Only a drop of 60% or more from the 0' level was considered to be a positive result.

RESULTS

The mean QPTH level at time 0' for PHPT patients was 38.12 +/- 25.15 pmol/L (range 9.1-118 pmol/L). At 10 minutes post-excision of the hyperfunctioning gland (or glands), QPTH dropped by a mean of 73.80% to 9.89 +/- 18.78 pmol/L.

CONCLUSIONS

Intraoperative QPTH level measurement is helpful in parathyroid surgery. A drop of 60% or more from 0' level indicates a successful procedure, and further exploration should be avoided.