Intraoperative parathyroid hormone assay in patients with primary hyperparathyroidism

Introduction: Currently, parathyroidectomy represents the elective surgical treatment and the only one curative that relieves the patient of metabolic complications and improves the quality of life of the patient. Intraoperative confirmation of PTH is required to reflect the fact that the correct parathyroid gland has been extracted. Material and method: The study is retrospective. The period on which the data was gathered over a period of 2 years. The values of the PTH assay were obtained from blood drawn from the ipsilateral cephalic vein of the hyperproductive parathyroid gland: 1. at the moment of anesthesia induction; 2. at identification; 3. at 10 minutes after the extraction; 4. at 20 minutes after extraction. Results: We identified a number of 25 patients operated for primary hyperparathyroidism. Preoperative values of PTH were 380pg/mL with a maximum value of 821 pg/mL. PTH values decreased by 55% at 5 min, 68% at 10 minutes and 74% at 15 minutes. A marked reduction in PTH values occurred after the first 5 minutes while the interval between 10-15minutes associated a variation of only 8-10% decrease. Conclusion: Intraoperative PTH assay is a useful technique to predict the success of the intervention. The technique is standard although some issues have been raised and are still under discussion.