A Retrospective Study of the Impact of Intraoperative Intact XXXX Monitoring During Total Parathyroidectomy for @entity3528 : STARD Study.

@entity1 @entity3528 @entity3243 @entity2742 @entity461
The study aimed to evaluate the diagnostic accuracy of intraoperative intact @entity461 (IO-iPTH) in @entity1 with @entity3528 ( @entity2742 ). The cut-off for IO-iPTH monitoring remains unknown. This was a single-center retrospective review of 226 consecutive @entity1 (107 males and 119 females) who underwent parathyroidectomy for secondary @entity2742 between May 2010 and March 2014. The predetermined cut-off for IO-iPTH was a 70% IO-iPTH drop from baseline 10 minutes after total parathyroidectomy and thymectomy. We used <60 pg/mL iPTH value on postoperative day 1 (POD1) as an indicator of successful removal of parathyroid glands and reviewed the frequency of reoperation other than in autografted sites during the observation period. This study was based on the Standards for the Reporting of Diagnostic accuracy compliant. The reoperation rate in @entity1 with >60 pg/mL iPTH value (POD1) was significantly higher than that in @entity1 with <60 pg/mL iPTH value (POD1), (13.0% versus 0.5% P = 0.003). Sensitivity, specificity, and accuracy of >70% IO-iPTH drop were 97.5%, 52.2%, and 92.9%, respectively, this criterion was demonstrated to be beneficial in 26 @entity1 . In 5 @entity1 , <70% IO-iPTH drop was observed and further exploration enabled sufficient removal of parathyroid glands. In 21 @entity1 , although fewer than 4 parathyroid glands were removed after enough explorations, >70% IO-iPTH drop enabled termination of operations and iPTH value (POD1) was <60 pg/mL.An iPTH value of <60 pg/mL (POD1) was a good predictor for successful parathyroidectomy. A 70% IO-iPTH drop from the baseline was appropriate to determine sufficient @entity3243 during parathyroidectomy for @entity1 with secondary @entity2742 . [Corrected]
