Intraoperative Parathyroid Hormone Monitoring: Optimal Utilization

Kepal N Patel; Raul Caso

doi:10.1016/j.soc.2015.08.005

Intraoperative Parathyroid Hormone Monitoring: Optimal Utilization

Surg Oncol Clin N Am. 2016 Jan;25(1):91-101. doi: 10.1016/j.soc.2015.08.005. Epub 2015 Oct 31.

Authors

Kepal N Patel¹, Raul Caso²

Affiliations

¹ Division of Endocrine Surgery, Department of Surgery, NYU Langone Medical Center, New York, NY, USA; Department of Biochemistry and Molecular Pharmacology, NYU Langone Medical Center, New York, NY, USA; Department of Otolaryngology, NYU Langone Medical Center, New York, NY, USA. Electronic address: kepal.patel@nyumc.org.
² NYU School of Medicine, New York, NY, USA.

PMID: 26610776
DOI: 10.1016/j.soc.2015.08.005

Abstract

Intraoperative parathyroid hormone (IOPTH) monitoring is a highly accurate surgical adjunct used to determine the extent of surgery in the setting of primary hyperparathyroidism. It is the successful interpretation of changes in PTH levels that is essential for using this technique in a way to optimize cure. Thus, it is imperative that the surgeon has an understanding of PTH dynamics and carefully chooses the appropriate IOPTH protocol and interpretation criteria that will best predict operative success, minimize unnecessary bilateral exploration, decrease the likelihood of resecting parathyroid glands that are not hypersecreting, and prevent recurrence.

Keywords: Intraoperative PTH monitoring; Minimally invasive parathyroidectomy; PTH; Primary hyperparathyroidism.

Publication types

Review

MeSH terms

Adult
Aged
Female
Humans
Hyperparathyroidism, Primary / surgery*
Male
Middle Aged
Minimally Invasive Surgical Procedures / methods
Monitoring, Intraoperative / methods*
Parathyroid Hormone / blood*
Parathyroidectomy / methods*

Substances

Parathyroid Hormone