Utility of Intraoperative Parathormone Assay as an Index to Successful Parathyroidectomy

Abstract

Introduction. Surgery is the definitive treatment for primary hyperparathyroidism (PHP). Focused approaches for excision of single gland pathology are gaining popularity. Preoperative parathyroid localization and intraoperative parathormone (IOPTH) assay are essential components of successful parathyroidectomy using focused approach. Objective. To evaluate the efficacy of IOPTH in patients undergoing surgery for PHP. Methods. Retrospective review of twelve patients who underwent surgery for PHP at tertiary corporate hospital in Mumbai, India, between January 2009 and December 2012. Results. IOPTH had true results in 10 patients (83%) and led to unnecessary further exploration in 1 patient (8%). The concordance rate between ultrasonogram, sestamibi, and IOPTH was 66%. The mean decay of IOPTH was 65%, and all patients were normocalcemic at the end of six months. Conclusion. IOPTH is a useful adjunct to predict successful removal of the involved gland.