Intraoperative parathyroid hormone in strategy of surgical treatment of a primary hyperparathyreosis

Abstract

Problem of surgical treatment of patients with a primary hyperparathyreosis – normalisation of level of a parathyroid hormone and calcium after operation. Any of diagnostics methods before operation does not allow to prognosticate authentically necessary volume of an operative measure in each specific case in this connection, was considered obligatory bilateral intraoperative revision of regions of a typical locating of parathyroids. Appearance of a method of definition of an quick parathyroid hormone during operation has allowed to estimate adequacy of a surgical intervention already on an operating table. Besides, it is a method allows to minimise an operational trauma and duration of a surgical intervention, and also widely to use the video-assisted operative measures in treatment of a primary hyperparathyreosis. We make the retrospective analysis of results of definition intraoperative parathyroid hormone at 230 patients with the primary hyperparathyreosis, operated in Endocrinologic centre of science in Moscow (Russia) from 2006 for 2009. Depending on success of the operative measure, all patients are parted on 4 bunches, according to the received results of concordance and research discordance. The analysed results have shown high sensitivity (93.3%), high specificity (85.7%), and also high predictive value of a positive take (99.5%) definitions intraoperative parathyroid hormone that allows to be oriented on its indexes at a choice of operational strategy in surgical treatment of a primary hyperparathyreosis.

Keywords

• paraadenoma
• quick parathyroid hormone
• intraoperative parathyroid hormone
• parathyroidectomy