Application of Intraoperative Quick Parathyroid Hormone Assay in the Surgical Management of Hyperparathyroidism

Objective:To introduce the method,curing criterion and clinical character of intraoperative quick parathyroid hormone assay in the surgical management of hyperparathyroidism.Methods:Plasma samples were obtained from 3 patients with hyperparathyroidism before skin incision and 20 minute after removal of abnormal parathyroid tissue.Intraoperative quick parathyroid hormone assay was performed.The criterion of operative success was defined by a decrease of PTH greater than 50% of pre-excision value.Results:In 3 patients with hyperparathyroidism,a 50% decrease of PTH in 1 case,normal of PTH falling in 1case,lower normal of PTH drop in 1case(tertiary hyperparathyroidism) occurred.In 1case with tertiary hyperparathyroidism,PTH value changed slightly after excising two parathyroid tissue and PTH value decreased below normal after excising third parathyroid tissue.The hypocalcemia in 3 patients represented after operation.Hypocalcemia return to normal by supplementary calcium.There were normal blood calcium and PTH after half a year of follow-up.Conclusion:Intraoperative quick parathyroid hormone assay is a useful tool to determine whether all hyperfunctioning parathyroid tissue has been removed during Parathyroidectomy.