Comparison of quick parathyroid assay for uniglandular and multiglandular XXXX .

@entity1 @entity66 @entity1373 @entity177 @entity8611 @entity460 @entity954 @entity3243 @entity652 @entity2742
BACKGROUND: The quick intraoperative parathyroid assay (qPTH) has been proposed as an effective tool in the surgical management of @entity2742 . This assay may facilitate directed, unilateral exploration for @entity66 ; however, its role in the management of @entity66 remains unclear. The purpose of this study is to evaluate the use of qPTH in parathyroid surgery, and to compare the results for @entity66 . METHODS: A prospective analysis of 63 consecutive @entity1 explored for @entity2742 using the qPTH assay was performed. Preoperative localization studies including ultrasonography and sestamibi scan were routinely obtained. Blood samples for qPTH were routinely drawn prior to the @entity954 , prior to gland excision, as well as 5 and 10 minutes after gland excision. @entity1 with primary or secondary @entity1373 had blood samples drawn relative to a 3-1/2 gland resection. Additional samples were drawn as needed for @entity1 with a double @entity652 . A qPTH decline of greater than or equal to 50% of the highest preincision or gland preexcision level was considered successful. Unilateral neck exploration was routinely performed unless @entity66 was identified. @entity1 were followed up postoperatively with serum @entity460 levels and an 8-month median follow-up was recorded. RESULTS: Forty-nine of 63 (78%) @entity1 were found to have a solitary @entity3243 . The qPTH assay was successful in 48 (97%) @entity1 with @entity66 . Forty-four of these 48 @entity1 showed an appropriate assay decline 5 minutes after @entity652 excision. One @entity1 with a single @entity652 showed a delayed 50% decline in qPTH at 20 minutes. Fourteen (22%) @entity1 were found to have @entity66 : 6 @entity1 with @entity1373 , 4 @entity1 with @entity1373 secondary to @entity177 , and 4 @entity1 with double @entity652 . All @entity1 with @entity66 demonstrated a successful decrease in qPTH levels. All @entity1 with @entity1373 secondary to @entity177 showed a successful assay decline 5 minutes after 3-1/2 gland resection. Eight of 14 (57%) @entity1 with @entity66 (4 double @entity652 , and 4 @entity1373 ) were suspected to have solitary @entity652 preoperatively. Overall, 62 of 63 (98%) @entity1 showed an appropriate assay decline within 10 minutes after gland excision. Postoperatively, all @entity1 were normocalcemic with a median follow-up of 8 months. CONCLUSIONS: These data suggest that qPTH can accurately facilitate unilateral, directed neck exploration for uniglandular @entity8611 , as well as guide the extent of gland resection for @entity66 . This assay reliably eliminates the most common cause of @entity177 , which is unrecognized @entity66 . The qPTH assay can reliably be used with similar accuracy for @entity1 with @entity66 as has been shown for uniglandular @entity8611 .
