Will intra-operative measurement of parathyroid hormone alter the surgical concept of renal hyperparathyroidism?

Excerpt

On the basis of the 2–3 min half-life, Nussbaum pioneered studies with an immunological rapid assay for intra-operative parathyroid hormone assessment (qPTH) [1]. Irvin then proved the feasibility and intra-operative usefulness of qPTH in surgery for primary hyperparathyroidism (pHPT) and paved the way for numerous studies relying on qPTH in favour of selective and minimally invasive approaches [2]. Despite several reports on the pitfalls and the obvious lack of long-term results, qPTH in surgery of pHPT not only evolved into a broad spectrum of innovative surgical techniques but challenged and ultimately altered the former gold standard of bilateral exploration. However, in the debate on the success criteria based on intra-operative qPTH, there is still some concern regarding qPTH as the decisive parameter of intra-operative strategy in pHPT. …