Objective: To explore the effect of intraoperative parathyroid hormone (IOPTH) monitoring in parathyroidectomy for Primary hyperparathyroidism. Method: The clinical data of 41 PHPT patients who received IOPTH monitoring (IOPTH group) during surgery from January 2009 to December 2014 were retrospectively analyzed. The clinical manifestation, examination and changes of parathyroid hormone and Calcium before and after operation were collected. Result: There were 12 males and 29 females (Parathyroid adenoma 36 cases, parathyroid carcinoma 5 cases). 23 caases were positive in 24 cases of Tc-99m-MIBI parathyroid adenoma radionuclide examination, 2 cases were positive in 3 cases of parathyroid carcinoma radionuclide Tc-99m-MIBI inspection (p=0.213). 10 min after tumor resection, PTH decreased by 50% or more than preoperative PTH level in all cases except for one case of parathyroid carcinoma. 23 cases appeared hypocalcemia in 36 cases of parathyroid adenoma postoperative and 2 cases appeared hypocalcemia in 5 cases of parathyroid cancer patients (P=0.361). No postoper-ative hoarseness, cough, bleeding appeared. Patients were followed up from 6 to 72 months, hypocalcemia symptoms recovered 2 weeks to 3 months later after surgery. No permanent hypoparathyroidism appeared. One case of parath-yroid carcinoma died of hypercalcemia five months after surgery, The remaining 40 cases survived without recurrence and deaths. Conclusion: Intraoperative PTH monitoring can help surgeons analyze whether all the hyperthyroidism gland have been removed in order to avoid missing multiple gland disease and avoid unnecessary bilateral neck exploration. This method has high accuracy, so it is recommended to routinely use in PHPT surgery.
[1]Jilin Univ, Hosp 1, Dept Dermatol, Changchun, Jilin, Peoples R China.
[2]Jilin Univ, Hosp 1, Dept Thyroid Surg, Changchun, Jilin, Peoples R China.
[3]Jilin Univ, Hosp 1, Daytime Observat Ward, Changchun, Jilin, Peoples R China.
[4]Jilin Univ, China Japan Union Hosp, Dept Orthopaed Surg, Changchun, Jilin, Peoples R China.
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