Intraoperative Parathyroid Hormone Assay Remains Predictive of Cure in Renal Impairment in Patients with Single Parathyroid Adenomas

Egan, Richard; Iliff, Helen; Stechman, Michael; Scott-Coombes, D

doi:10.1007/s00268-018-4544-7

Cited by 8 publications

(2 citation statements)

References 23 publications

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“…In 2018, Egan et al 24 evaluated the influence of renal function deterioration on the kinetics of ioPTH decrease in a cohort of patients with 1HPT of uniglandular etiology and undergoing successful PTx. The authors reported significant differences only with severe renal function impairment, stage 4 and 5 of chronic kidney disease (CKD), primarily at 5 minutes after PTx, but that the kinetics started to equalize after 10 minutes, despite more slowly in renal patients.…”

Section: Discussionmentioning

confidence: 99%

Delayed sampling of intraoperative parathormone may be unnecessary during parathyroidectomy in kidney-transplanted and dialysis patients

et al. 2021

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Introduction: Some authors advise in favor of delayed sampling of intraoperative parathormone testing (ioPTH) during parathyroidectomy in dialysis and kidney-transplanted patients. The aim of the present study was to evaluate the intensity and the role of delayed sampling in the interpretation of ioPTH during parathyroidectomy in dialysis patients (2HPT) and successful kidney-transplanted patients (3HPT) compared to those in single parathyroid adenoma patients (1HPT). Methods: This was a retrospective study of ioPTH profiles in patients with 1HPT, 2HPT, and 3HPT operated on in a single institution. Samples were taken at baseline ioPTH (sampling at the beginning of the operation), ioPTH-10 min (10 minutes after excision of the parathyroid glands), and ioPTH-15 min (15 minutes after excision of the parathyroid glands). The values were compared to baseline. Results: Median percentage values of ioPTH compared to baseline (100%) were as follows: 1HPT, ioPTH-10 min = 20% and ioPTH-15 min = 16%; 2HPT, ioPTH-10 min = 14% and ioPTH-15 min = 12%; 3HPT, ioPTH-10 min = 18% and ioPTH-15 min = 15%. Discussion: The reduction was equally effective at 10 minutes in all groups. In successful cases, ioPTH decreases satisfactorily 10 minutes after parathyroid glands excision in dialysis and transplanted patients, despite significant differences in kidney function. The postponed sampling of ioPTH appears to be unnecessary.

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Section: Discussionmentioning

confidence: 99%

Delayed sampling of intraoperative parathormone may be unnecessary during parathyroidectomy in kidney-transplanted and dialysis patients

et al. 2021

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“…The main target organs of PTH action are bone and kidney, which mobilize bone calcium into the blood and promote the reabsorption of calcium ions and the excretion of phosphate in renal tubules, so as to increase the level of blood calcium and decrease the level of blood phosphorus. In addition, PTH also indirectly promotes the intestinal absorption of calcium ions [13,14] .When tumor surgery, illness, or other causes PTH secretion decline, will cause the body hypocalcemia, and low blood calcium level will cause different clinical symptoms, light person such as oral and extremities numbness, cramps nervous system performance, the person that weigh can have syncope, arrhythmia, such as system performance, there are even suffocation crisis due to laryngospasm patient safety [15] . The role of PTH is so important, and in the thyroid surgery, parathyroid anatomical morphology and adipose tissue, lymphoid tissue is very close to the naked eye to distinguish the difficulty of a relatively large, and many patients parathyroid smaller or some position variation is larger, more increased injured or accidentally cut the risk of parathyroid gland, so parathyroid recognition and protection is of great urgency.…”

Section: Discussionmentioning

confidence: 99%

Study on Rapid Intraoperative Parathyroid Hormone to Identify and Protect Parathyroid Gland during Total Thyroidectomy

Ding¹,

Qian²,

Wáng³

et al. 2019

ijSciences

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Objective: By comparison and analysis preoperative and postoperative related indicators of the Control group (group A) and Fine-needle aspiration(FNA) rapid intraoperative parathyroid hormone (rIO-PTH) group (group B) .To further explore whether rIO-PTH has a certain value for the intraoperative identification and protection of the parathyroid glands, and reduce the incidence of hypoparathyroidism and hypocalcemia in postoperative. Improve the quality of life of patients with thyroidectomy. Methods: In this study, the patients were divided into group A, group B, with 35 cases in each group. In group B, the suspected parathyroid tissues was aspirated by FNA. Parathyroid gland was identified by the concentration of rIO-PTH in the puncture fluid. In group A, only in the traditional thyroid surgery way. Comparative analysis of postoperative PTH and blood calcium, numbers of intraoperative identification of parathyroid glands, the incidence of hypoparathyroidism and hypocalcemia in postoperative. Results: During the operation, the parathyroid glands were identified, the average of group A was (2.60.3), the average of group B was (3.00.2). There was a statistically significant difference in the average number of parathyroid glands between the two groups (P<0.05). Postoperative blood calcium and PTH levels were decreased in all the two groups, and the differences were statistically significant (p < 0.05) on the 1st, 4th, 7th and 30th day after surgery. The incidence of postoperative hypocalcemia was 28.6% (10/35) in group A and 8.6% (3/35) in group B. The incidence of postoperative hypothyroidism was 37.1% (13/35) in group A and 14.3% (5/35) in group B. The incidence of hypocalcemia and hypothyroidism in the two groups was statistically significant difference (P < 0.05). Conclusion: Fine-needle aspiration (FNA) rapid intraoperative detection of parathyroid hormone (rIO-PTH) can identify parathyroid tissue. rIO-PTH can significantly reduce the excessive reduction of postoperative blood calcium and PTH levels in patients, and effectively reduce the incidence of postoperative hypocalcemia and hypothyroidism. rIO-PTH has high clinical application value in identifying and protecting parathyroid gland in thyroid surgery.

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Intraoperative measurement of parathyroid hormone in hyperparathyroidism

Lorenz

Schneider

Elwerr

2020

Chirurg

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Intraoperative Parathyroid Hormone Assay Remains Predictive of Cure in Renal Impairment in Patients with Single Parathyroid Adenomas

Abstract: Although the reduction in ioPTH after successful parathyroidectomy is lower in severe CKD, the Miami criterion remains predictive of cure. Differences in absolute levels of PTH and tumour weight suggest that renal HPT may be a confounding factor.

Cited by 8 publications

References 23 publications

Delayed sampling of intraoperative parathormone may be unnecessary during parathyroidectomy in kidney-transplanted and dialysis patients

Delayed sampling of intraoperative parathormone may be unnecessary during parathyroidectomy in kidney-transplanted and dialysis patients

Study on Rapid Intraoperative Parathyroid Hormone to Identify and Protect Parathyroid Gland during Total Thyroidectomy

Intraoperative measurement of parathyroid hormone in hyperparathyroidism

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