Central Surgical AssociationIntraoperative parathyroid hormone testing improves cure rates in patients undergoing minimally invasive parathyroidectomy
Section snippets
Patients and methods
Between January 1990 and June 2004 there were 345 consecutive patients with 1°HPT and positive parathyroid localization studies for a single parathyroid adenoma who underwent neck exploration at the University of Wisconsin. On March 1, 2001, iPTH testing became available for clinical use at our institution. Subsequent to that date, all patients undergoing parathyroidectomy had iPTH testing during their operation.
During minimally invasive parathyroidectomy, our protocol for iPTH testing and
Preoperative data
The mean age of all 345 patients was 60 ± 3 years. The mean preoperative laboratory values included serum calcium concentrations of 11.3 ± 0.5 mg/dL and serum phosphorus concentrations of 2.7 ± 0.1 mg/dL. The mean preoperative serum intact PTH level was 150 ± 14 pg/mL. The mean preoperative alkaline phosphatase activity was 122 ± 6 mg/dL. We then compared the preoperative laboratory values between groups 1 and 2. As shown in Table I, there were no significant differences in age or preoperative
Discussion
Minimally invasive parathyroidectomy for 1°HPT is safe and associated with high cure rates in experienced hands.1, 2, 15, 16, 17 As shown by several investigators, minimally invasive parathyroidectomy when compared with bilateral explorations leads to lower hospital costs, shorter durations of stay, a lower incidence of hypocalcemia, and equally high cure rates with low complication rates.3, 4, 5, 7, 17, 18 Several operative adjuncts have been shown to facilitate minimally invasive parathyroid
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Presented at the 62nd Annual Meeting of the Central Surgical Association, Tucson, Arizona, March 10-15, 2005.