ArticleBrazilian journal of otorhinolaryngology2013
Intraoperative PTH cutoff definition to predict successful parathyroidectomy in secondary and tertiary hyperparathyroidism.
Article in Brazilian journal of otorhinolaryngology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Surgical management of presternal recurrence in hyperparathyroidism related to chronic kidney disease.Brazilian journal of otorhinolaryngology · 2026Article
- Pre-Parathyroidectomy PTH as an Integrated Biomarker of Glandular Remodeling and Skeletal Turnover in Secondary Hyperparathyroidism.International journal of molecular sciences · 2026Review
- Article
- Ectopic parathyroid and its role in surgical failure.Einstein (Sao Paulo, Brazil) · 2025Article
- Article
- Predictive value of characteristics of resected parathyroid glands for persistent secondary hyperparathyroidism during parathyroidectomy.BMC surgery · 2023Article
- Intraoperative Parathyroid Hormone Monitoring-Guided Subtotal Parathyroidectomy is an Effective and Valid Surgical Procedure for Secondary Hyperparathyroidism.Sisli Etfal Hastanesi tip bulteni · 2023Article
- Surgical treatment of tertiary hyperparathyroidism: does one fit for all?Frontiers in endocrinology · 2023Article
- PTH Spikes During Surgical Treatment for Secondary and Tertiary Hyperparathyroidism: A Prospective Observational Study.World journal of surgery · 2022Observational
- Diagnostic Accuracy of Intraoperative Intact Parathyroid Hormone Monitoring for Surgical Outcomes of Secondary Hyperparathyroidism.Medical science monitor : international medical journal of experimental and clinical research · 2021Article
- Review
- Lesion based diagnostic performance of dual phaseBMC medical imaging · 2017Article
- Initial surgical results of 500 Parathyroidectomies for Hyperparathyroidism related to chronic kidney disease - mineral and bone disorder.Jornal brasileiro de nefrologiaArticle
- COULD THE RATE OF DECREASE IN INTRAOPERATIVE PARATHYROID HORMONE LEVEL BE A DETERMINANT OF SURGICAL TECHNIQUE IN TERTIARY HYPERPARATHYROIDISM?Acta endocrinologica (Bucharest, Romania : 2005)Article
- Parathyroidectomy in chronic kidney disease.Jornal brasileiro de nefrologiaArticle
- Autotransplant tissue selection criteria with or without stereomicroscopy in parathyroidectomy for treatment of renal hyperparathyroidism.Brazilian journal of otorhinolaryngologyArticle
- Delayed sampling of intraoperative parathormone may be unnecessary during parathyroidectomy in kidney-transplanted and dialysis patients.Jornal brasileiro de nefrologiaArticle
- Sestamibi scan in renal parathyroidectomy: a worthwhile preoperative exam?Brazilian journal of otorhinolaryngologyArticle
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledIn order to improve success rates in surgery of renal hyperparathyroidism, we evaluated intraoperative PTH (IOPTH) measurement utility.
method86 patients underwent total parathyroidectomy with intramuscular presternal autotransplantation from 04/2000 to 10/2009 and were followed for 26.5 months on average (prospective cohort). Patients were divided in secondary (SHPT) and tertiary hyperparathyroidism (THPT). SHPT group was composed by patients under dialysis treatment, THPT group included renal grafted ones. IOPTH (Elecsys-PTH-Immunoassay/Roche) was measured at anesthesia induction (IOPTH-0') and 20 minutes (IOPTH-20') after parathyroidectomy.
results80.2% (69/86) presented with 80% decrease or more in the IOPTH-20' and all were cured. In 11/86 patients (12.7%), a lower IOPTH-20' drop (70-79%) was observed, and 2 of them (18.1%) failed to cure. 6/86 (6.9%) patients presented IO-PTH-20' decrease of less than 70%: two were cured, in three a supernumerary/ectopic parathyroid was found and removed, and in one of these six patients, surgery was finished after 4-gland excision and the patient failure to cure.
conclusionIOPTH-20' decrease of 80% or more compared to IOPTH-0' predicts cure in all renal patients throughout follow-up. A decay of less than 70% points to missed or hyperfunctioning supernumerary gland and is predictive of surgical failure in 66.6%. A marginal IOPTH drop of 70-79% leaves the decision whether or not surgery should be continued up to the experienced surgeon.
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