PRIMARY HYPERPARATHYROIDISM (PHPT): PROGNOSTIC SIGNIFICANCE OF INTRAOPERATIVE PATHORMONE SERUM LEVELS MONITORING (IOPTH) FOR PERSISTENT / RECURRENT PHPT
IOPTH has prognostic significance regarding persistence / recurrence of the PHPT. In general, the smaller the reduction of PTH levels, the higher the risk of persistence / recurrence of PHPT. Median intraoperative PTH decrease is lower in patients with persistent PHPT. Moreover, higher postoperative PTH levels is also a factor predicting recurrence. Patients with intraoperative failure (defined as failure to decrease PTH levels intraoperatively by > 50 %) have more frequently multiglandular disease (x 2) and smaller glands compared to the patients who experience intraoperative success. Long-term recurrence is more likely in patients with a final intraoperative PTH level of 41 – 65 pg/ml than with a level < 40 pg/ml.

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