Evaluation of Halle, Miami, Rome, and Vienna intraoperative iPTH assay criteria in guiding minimally invasive parathyroidectomy

Barczyński, Marcin; Konturek, Aleksander; Hubalewska‐Dydejczyk, Alicja; Cichoń, S; Nowak, Wojciech

doi:10.1007/s00423-009-0510-z

Cited by 155 publications

(144 citation statements)

References 24 publications

Supporting

Mentioning

129

Contrasting

Unclassified

Order By: Relevance

“…When compared to previous years, this modifi cation increased the success of the operation for 0.50 % (Adámek et al, 2005). For the measurement of intact parathormone, different criteria exist (Barczynski et al, 2009). The blood sample is taken before the surgical incision and after the parathyroid gland removal (Riss et al, 2007a).…”

Section: Discussionmentioning

confidence: 99%

Measurement of intact parathormone during operation for primary hyperparathyroidism

Libánský¹,

Adámek²,

Broulík³

et al. 2017

BLL

View full text Add to dashboard Cite

In this prospective study, the role of the intact parathormone (iPHT) levels for the verifi cation of pathologic parathyroid tissue removal during parathyroidectomy, was analyzed in 441 patients diagnosed with primary hyperparathyroidism. The level of intact parathormone was obtained before the initial incision (baseline level) and 10 minutes after the pathologic parathyroid gland removal (control value). In 80 % of cases, the decrease of intact parathormone was more than 50 % of the baseline level. The comparison of preoperative and postoperative intact parathormone levels can also be used as marker of parathyroid hyperplasia or persistent hyperparathyroidism. This method is necessary mainly for performance of focused, miniinvasive approaches as well as in reoperations. This method is of signifi cant benefi t in cases of negative preoperative examination methods. The determination of intact parathormone level increases the success of parathyroidectomy (Ref. 26). Text in PDF www.elis.sk.

show abstract

Section: Discussionmentioning

confidence: 99%

Measurement of intact parathormone during operation for primary hyperparathyroidism

Libánský¹,

Adámek²,

Broulík³

et al. 2017

BLL

View full text Add to dashboard Cite

show abstract

“…Advantages of this surgical option include better cosmetic outcome, as the incision is smaller, use of local or light general anesthesia, shorter operating time and hospital stay, lower hospital costs, better surgical conditions if reoperation is needed, preservation of normal parathyroid glands, decreased post-operative hypocalcemia, and/or risk of bilateral recurrent laryngeal nerve injury. However, adjuvant techniques as IOPTH increase the final cost of MIP (18)(19)(20)(21)(22)(23)(24).…”

Section: Treatmentmentioning

confidence: 99%

“…It is not an advisable option for patients with negative or discordant imaging localization studies, known genetic syndromes, secondary or tertiary hyperparathyroidism, multiglandular disease, extra-cervical ectopy, parathyroid carcinoma, large goiter, or need for thyroidectomy (18)(19)(20)(21)(22)(23)25,26).…”

Section: Treatmentmentioning

confidence: 99%

“…On the grounds of the Rome criterion, IOPTH 20 minutes post-excision should be within the reference range and/or less than 50% of the highest pre-excision level and/or at least 7.5 ng/L lower than IOPTH assay at 10 minutes post-excision. Based on the Vienna criteria, a decline in IOPTH levels of over 50% (from pre--operative baseline to 10 minutes post-excision) would predict surgical cure (19,27).…”

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Persistent primary hyperparathyroidism: an uncommon location for an ectopic gland - Case report and review

Gouveia

Rodrigues

Barros

et al. 2012

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

SUMMARYPrimary hyperparathyroidism (PHPT) is a common endocrine disorder that mainly affects middleaged women. Patients are usually asymptomatic. The disease might be ascribable to hyperplasia, carcinoma, and single or multiple adenomas. PHPT may be sporadic or familial, the latter comprising multiple endocrine neoplasia type 1 or 2A, familial benign hypocalciuria hypercalcemia, and hyperparathyroidism-jaw tumor syndrome. The most common causes for persistent PHPT are multiglandular disease, and missed abnormal ectopic or orthotopic parathyroid glands. Ima ging localization studies should precede a new surgical intervention. Ectopic parathyroid glands are rarely located at the aortopulmonary window. For diagnosis confirmation, Tc-sestamibi SPECT/CT seems to be an advantageous test. Another possibility is to perform 99m Tc-sestamibi followed by thoracic CT or MRI. Parathyroidectomy may be performed by means of median sternotomy, thoracotomy, or video-assisted thoracoscopy. We describe a case of persistent primary hyperparathyroidism due to the presence of an ectopic parathyroid gland found at the aortopulmonary window. As the investigation necessary to clarify the etiology of recurrent nephrolithiasis proceeded, the diagnosis of PHPT was determined. The patient underwent subtotal parathyroi dectomy; nevertheless, PHPT persisted. Genetic syndromes that could account for this condition were excluded. Imaging studies available at that time were not able to locate abnormal glands; moreover, the patient refused to undergo surgical exploration. Later, the patient underwent 99m Tc-sestamibi SPECT/CT, which revealed a parathyroid gland at the aortopulmonary window. Arq Bras Endocrinol Metab. 2012;56(6):393-403 SUMÁRIO O hiperparatiroidismo primário (HPP) é uma endocrinopatia frequente que afeta maioritariamente mulheres de meia-idade e é geralmente assintomática. A doença pode ser atribuível a hiperplasia, carcinoma, adenomas únicos ou múltiplos. O HPP inclui formas esporádicas e familiares. As formas familiares englobam neoplasia endócrina múltipla tipo 1 ou 2A, hipercalcemia hipocalciúrica familiar e síndrome hiperparatiroidismo/tumor mandibular-maxilar. As causas mais frequentes de HPP persistente são a presença de doença multiglandular ou de paratiroide anômala ectópica ou ortotópica não identificada previamente. É recomendável que a localização imagiológica preceda a reintervenção cirúrgica. A janela aortopulmonar é uma localização ectópica rara, sendo o 99m Tcsestamibi SPECT/TC um exame de confirmação vantajoso ou, alternativamente o 99m Tc-sestamibi seguido de TC ou RM torácica. A paratiroidectomia pode ser efetuada por meio de esternotomia mediana, toracotomia ou toracoscopia videoassistida. Descrevemos um caso de HPP persistente atribuível à presença de uma glândula paratiroide ectópica localizada à janela aortopulmonar. O diagnóstico de HPP foi estabelecido na sequência da investigação requisitada para esclarecimento etiológico da nefrolitíase recidivante constatada nessa doente. Foi submetida à paratiroidec...

show abstract

“…There have been several studies comparing strategies for IOPTH testing. (Chiu et al, 2006;Carneiro et al, 2003;Barczynski et al, 2009) Barczynski et al studied 260 patients with presumed solitary parathyroid adenomas based on concordant localization studies. The Miami criterion had the highest accuracy (97%) compared to the Halle (PTH level low normal at 15 minutes), Rome (>50% decline to normal at 20 minutes and / or < 7.5ng/L lower than the 10-minute value), and Vienna (≥50% decline at 10-minutes) criteria.…”

Section: Iopthmentioning

confidence: 99%

Minimally Invasive Parathyroidectomy for Primary Hyperparathyroidism - Current Views, Issues and Controversies

Wong¹,

Lang²

2012

Hyperparathyroidism

View full text Add to dashboard Cite

Evaluation of Halle, Miami, Rome, and Vienna intraoperative iPTH assay criteria in guiding minimally invasive parathyroidectomy

Cited by 155 publications

References 24 publications

Measurement of intact parathormone during operation for primary hyperparathyroidism

Measurement of intact parathormone during operation for primary hyperparathyroidism

Persistent primary hyperparathyroidism: an uncommon location for an ectopic gland - Case report and review

Minimally Invasive Parathyroidectomy for Primary Hyperparathyroidism - Current Views, Issues and Controversies

Contact Info

Product

Resources

About