PRIMARY
HYPERPARATHYROIDISM (PHPT)– IS INTRAOPERATIVE PARATHORMONE MEASUREMENT (IOPTH)
ALWAYS NECESSARY?
IOPTH is a
useful tool to confirm the success of surgery for PHPT. However, the use of
IOPTH is of little added value when preoperative localization (using sestamibi
scan [SS] and ultrasonography [US]) indicates single-gland disease.
In
contrast, IOPTH is MANDATORY:
1.When a
‘focused’ parathyroidectomy is performed on the basis of a single preoperative
localization study.
2.When
results of SS and US are not concordant and the surgeon select a ‘focused’
(targeted) parathyroidectomy
3.In reoperative
parathyroidectomy for recurrent / persistent PHPT
In
practice, however, many endocrine surgeons have adopted the strategy of routine
IOPTH to confirm effective treatment of PHPT.
[ESES]
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