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01-09-2008 | Current Concepts in Endocrine Surgery

Intraoperative PTH monitoring during parathyroidectomy: the need for stricter criteria to detect multiglandular disease

Authors: Celestino Pio Lombardi, Marco Raffaelli, Emanuela Traini, Enrico Di Stasio, Cinzia Carrozza, Carmela De Crea, Cecilia Zuppi, Rocco Bellantone

Published in: Langenbeck's Archives of Surgery | Issue 5/2008

Abstract

Purpose

Usefulness of rapid intraoperative parathyroid hormone assay (RI-PTH) for diagnosis of multiglandular disease during parathyroidectomy is still debated.

Materials and methods

Two hundred seven patients were selected for focused parathyroidectomy for a suspicious single adenoma. RI-PTH results were interpreted on the basis of our criteria for prediction of multiglandular disease (a < 50% drop from the highest pre-excision level and/or a T20 concentration higher than reference range and/or >7.5 ng/L higher than the T10). The results of these criteria were compared with the Miami Criterion (MC).

Results

One hundred ninety-seven uniglandular disease and ten multiglandular disease were found. Our criteria identified all but one patient with multiglandular disease (false positive (FP) rate 0.5%; specificity 90%). On the basis of MC, RI-PTH monitoring would have resulted in five FP results, with a specificity of 50%.

Conclusions

Despite the higher rate of unnecessary bilateral exploration, our criteria results in a lower FP, markedly reducing the risk of missing multiglandular disease.

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Title: Intraoperative PTH monitoring during parathyroidectomy: the need for stricter criteria to detect multiglandular disease
Authors: Celestino Pio Lombardi
Marco Raffaelli
Emanuela Traini
Enrico Di Stasio
Cinzia Carrozza
Carmela De Crea
Cecilia Zuppi
Rocco Bellantone
Publication date: 01-09-2008
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 5/2008
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-008-0384-5

At a glance: The STEP trials

Springer Medicine

Intraoperative PTH monitoring during parathyroidectomy: the need for stricter criteria to detect multiglandular disease

Abstract

Purpose

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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