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The role of intraoperative measurement of parathyroid hormone in parathyroid surgery.
Pellitteri, Phillip K.
Afiliación
  • Pellitteri PK; Head, Neck and Endocrine Surgery, Geisinger Health System, Danville, Pa. 18722-1333, USA.
Article en En | MEDLINE | ID: mdl-18971597
Technological developments have significantly contributed to the rapid evolution of the surgical management of parathyroid disorders. The ability to physiologically determine the intraoperative status of the patient is now possible through the assessment of changing levels of intact parathyroid hormone (PTH) during surgery. In most patients with primary hyperparathyroidism, this method provides biochemical confirmation of hyperfunctional gland removal, and is predictive of a eucalcemic state and surgical cure. Patients with renal-induced disease (excluding tertiary hyperparathyroidism) do not follow the same kinetic decline in PTH and are therefore less likely to benefit from this modality. An emerging population of patients with primary disease and lower baseline levels of intact PTH appear to demonstrate a greater likelihood of manifesting multiple gland disease and do not follow a consistently predictable kinetic degradation profile. Although this category of patients will require further investigation, potentially resulting in modification of the utility of intraoperative determination of PTH levels, it is clear that this modality represents a very powerful technique which has significantly enhanced the surgical treatment of parathyroid disease.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de las Paratiroides / Hormona Paratiroidea / Monitoreo Intraoperatorio Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: ORL J Otorhinolaryngol Relat Spec Año: 2008 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de las Paratiroides / Hormona Paratiroidea / Monitoreo Intraoperatorio Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: ORL J Otorhinolaryngol Relat Spec Año: 2008 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza