Central venous parathyroid hormone monitoring using a novel, specific anatomic method accurately predicts cure during minimally invasive parathyroidectomy
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- 作者：Courtney M. Edwards ; M.D.a ; Jessica Folek ; M.D.b ; Samantha Dayawansa ; M.D. ; Ph.D.a ; Cara M. Govednik ; M.D.c ; Courtney E. Quinn ; M.D.d ; Benjamin R. Sigmond ; M.D.e ; Cortney Y. Lee ; M.D.f ; Melissa S. Angel ; R.N. ; M.S.N. ; F.N.P.-C.a ; John C. Hendricks ; M.D.a ; Terry C. Lairmore ; M.D.a ; Terry.Lairmore@BSWHealth.org
- 关键词：Parathyroidectomy ; Intraoperative PTH ; Minimally invasive surgery
- 刊名：The American Journal of Surgery
- 出版年：2016
- 出版时间：December 2016
- 年：2016
- 卷：212
- 期：6
- 页码：1154-1161
- 全文大小：638 K
- 卷排序：212
文摘
Measurement of intraoperative parathyroid hormone (PTH) levels is an important adjunct to confirm biochemical cure during parathyroidectomy. The purpose of this study was to evaluate a simplified anatomic technique for PTH sampling from the central veins through the minimally invasive neck incision, and to compare the predictive accuracy of central and peripheral PTH values.MethodsA specific anatomic method for central PTH sampling was employed in 48 patients. Samples were drawn simultaneously from peripheral and central veins at baseline and 10 minutes postexcision of all hyperfunctioning parathyroid glands.ResultsThe central venous PTH levels independently predicted biochemical cure according to the Miami criterion in all the patients. There was no significant difference in the postexcision central and peripheral values, which were 24.40 + 1.86 and 21.69 + 1.74, respectively (P = .877, ANOVA test).ConclusionsThis study provides the original description of a simplified technique for measurement of intraoperative PTH levels in the central veins with direct comparison to peripheral venous levels, and confirmation of accuracy in predicting biochemical cure when relying on centrally obtained values alone.