Intraoperative Parathyroid Hormone Monitoring in the Surgical Management of Sporadic Primary Hyperparathyroidism
Endocrinology and Metabolism
;
: 327-339, 2019.
Artigo
em Inglês
| WPRIM
| ID: wpr-785730
ABSTRACT
Intraoperative parathyroid hormone monitoring (IPM) has been shown to be a useful adjunct during parathyroidectomy to ensure operative success at many specialized medical centers worldwide. Using the Miami or “>50% intraoperative PTH drop” criterion, IPM confirms the complete excision of all hyperfunctioning parathyroid tissue before the operation is finished, and helps guide the surgeon to identify additional hyperfunctioning parathyroid glands that may necessitate further extensive neck exploration when intraoperative parathyroid hormone (PTH) levels do not drop sufficiently. The intraoperative PTH assay is also used to differentiate parathyroid from non-parathyroid tissues during operations using fine needle aspiration samples and to lateralize the side of the neck harboring the hypersecreting parathyroid through differential jugular venous sampling when preoperative localization studies are negative or equivocal. The use of IPM underscores the recognition and understanding of sporadic primary hyperparathyroidism (SPHPT) as a disease of function rather than form, where the surgeon is better equipped to treat such patients with quantitative instead of qualitative information for durable long-term operative success. There has been a significant paradigm shift over the last 2 decades from conventional to focused parathyroidectomy guided by IPM. This approach has proven to be a safe and rapid operation requiring minimal dissection performed in an ambulatory setting for the treatment of SPHPT.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Hormônio Paratireóideo
/
Glândulas Paratireoides
/
Monitorização Intraoperatória
/
Paratireoidectomia
/
Procedimentos Cirúrgicos Minimamente Invasivos
/
Biópsia por Agulha Fina
/
Hiperparatireoidismo Primário
/
Cirurgiões
/
Pescoço
Tipo de estudo:
Estudo prognóstico
/
Pesquisa qualitativa
Limite:
Humanos
Idioma:
Inglês
Revista:
Endocrinology and Metabolism
Ano de publicação:
2019
Tipo de documento:
Artigo
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