Intraoperative Parathyroid Hormone Monitoring In Primary Hyperparathyroidism Patients Undergoing Surgery

ABSTRACT

Background: Primary hyperparathyroidism (PHPT) is anendocrine disorder characterized by autonomous production ofparathyroid hormone (PTH). We planned the present study toevaluate the level of PTH intraoperatively and postoperativelyand determine the outcome of the surgery.Materials & Methods: A total of 36 patients scheduled toundergo parathyroidectomy for hyperparathyroidism wereinvolved in the present study. Complete physical examinationof all the subjects was carried out. Pre-surgical assessment ofall the subjects was done. Minimally invasiveparathyroidectomy (MIP) was done in all the patients. A 50%reduction in PTH level from baseline was used as an indicationthat the exploration was successful. If a parathyroid adenomawas not found or if the PTH did not drop sufficiently after theremoval of the gland, the incision was extended and bilateralneck exploration was done.Results: MIP was carried out in 33 patients, while bilateralneck exploration was required in 3 patients. A significantdecline in the mean PTH concentration was seen duringsurgery and postoperatively. Also we observed a significant fallin the postoperative calcium levels in comparison to thepreoperative calcium levels.Conclusion: Intraoperative PTH monitoring plays a significantand crucial role in assessing the surgical treatment of primaryhyperparathyroidism.