Utilidad de la PTH intraoperatoria como predictor de curación quirúrgica en hiperparatiroidismo primario

Background: The aim of the surgical treatment of primary hyperparathyroidism (PHPT) is to achieve its complete cure, evidenced by normal serum calcium in the postoperative period. Measurement of intraoperative serum parathormone (PTH) can be useful to predict complete cure of the disease. Aim: To as...

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Autores principales: Domínguez,José Miguel, Velasco,Soledad, Goñi,Ignacio, León,Augusto, González,Hernán, Claure,Raúl, Arteaga,Eugenio, Campusano,Claudia, Fardella,Carlos, López,José Manuel, Mosso,Lorena, Rodríguez,José Adolfo, González,Gilberto
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 2009
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Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872009001200007
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spelling oai:scielo:S0034-988720090012000072010-05-24Utilidad de la PTH intraoperatoria como predictor de curación quirúrgica en hiperparatiroidismo primarioDomínguez,José MiguelVelasco,SoledadGoñi,IgnacioLeón,AugustoGonzález,HernánClaure,RaúlArteaga,EugenioCampusano,ClaudiaFardella,CarlosLópez,José ManuelMosso,LorenaRodríguez,José AdolfoGonzález,Gilberto Parathyroid diseases Hyperparathyroidism, primary Parathyroid hormone Background: The aim of the surgical treatment of primary hyperparathyroidism (PHPT) is to achieve its complete cure, evidenced by normal serum calcium in the postoperative period. Measurement of intraoperative serum parathormone (PTH) can be useful to predict complete cure of the disease. Aim: To assess the usefulness of intraoperative PTH measurement to predict complete cure of PHPT Material and methods: Serum PTH was measured to all patients operated for PHPT between 2003 and 2008, before and five and ten minutes after the excision of the parathyroid gland causing the disease. The criteria for complete cure were normal serum calcium at 24 hours and 6 months after surgery and the pathological confirmation of parathyroid gland excision. Results: Eighty-eight operated patients, aged 58±15 years (72 females) were studied. Sixty four percent were asymptomatic and their preoperative serum calcium was 11.6± 1.2 mg/dl. A normal serum calcium was achieved in 86 patients (98%) at 24 hours and 50 of 52 patients followed for six months (96%). The pathological study disclosed an adenoma in 69 (78%), and multiglandular disease in 16 (18%), a parathyroid cancer in one and a normal gland in one patient. Intraoperative PTH predicted early and definitive cure in 97% and 100% of patients with a single adenoma, respectively. Among patients with multiglandular disease, the predictive figures were 94% and 100%, respectively. Conclusions: Intraoperative PTH measurement efficiently predicts early and definitive surgical cure of PHPT.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.137 n.12 20092009-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872009001200007es10.4067/S0034-98872009001200007
institution Scielo Chile
collection Scielo Chile
language Spanish / Castilian
topic Parathyroid diseases
Hyperparathyroidism, primary
Parathyroid hormone
spellingShingle Parathyroid diseases
Hyperparathyroidism, primary
Parathyroid hormone
Domínguez,José Miguel
Velasco,Soledad
Goñi,Ignacio
León,Augusto
González,Hernán
Claure,Raúl
Arteaga,Eugenio
Campusano,Claudia
Fardella,Carlos
López,José Manuel
Mosso,Lorena
Rodríguez,José Adolfo
González,Gilberto
Utilidad de la PTH intraoperatoria como predictor de curación quirúrgica en hiperparatiroidismo primario
description Background: The aim of the surgical treatment of primary hyperparathyroidism (PHPT) is to achieve its complete cure, evidenced by normal serum calcium in the postoperative period. Measurement of intraoperative serum parathormone (PTH) can be useful to predict complete cure of the disease. Aim: To assess the usefulness of intraoperative PTH measurement to predict complete cure of PHPT Material and methods: Serum PTH was measured to all patients operated for PHPT between 2003 and 2008, before and five and ten minutes after the excision of the parathyroid gland causing the disease. The criteria for complete cure were normal serum calcium at 24 hours and 6 months after surgery and the pathological confirmation of parathyroid gland excision. Results: Eighty-eight operated patients, aged 58±15 years (72 females) were studied. Sixty four percent were asymptomatic and their preoperative serum calcium was 11.6± 1.2 mg/dl. A normal serum calcium was achieved in 86 patients (98%) at 24 hours and 50 of 52 patients followed for six months (96%). The pathological study disclosed an adenoma in 69 (78%), and multiglandular disease in 16 (18%), a parathyroid cancer in one and a normal gland in one patient. Intraoperative PTH predicted early and definitive cure in 97% and 100% of patients with a single adenoma, respectively. Among patients with multiglandular disease, the predictive figures were 94% and 100%, respectively. Conclusions: Intraoperative PTH measurement efficiently predicts early and definitive surgical cure of PHPT.
author Domínguez,José Miguel
Velasco,Soledad
Goñi,Ignacio
León,Augusto
González,Hernán
Claure,Raúl
Arteaga,Eugenio
Campusano,Claudia
Fardella,Carlos
López,José Manuel
Mosso,Lorena
Rodríguez,José Adolfo
González,Gilberto
author_facet Domínguez,José Miguel
Velasco,Soledad
Goñi,Ignacio
León,Augusto
González,Hernán
Claure,Raúl
Arteaga,Eugenio
Campusano,Claudia
Fardella,Carlos
López,José Manuel
Mosso,Lorena
Rodríguez,José Adolfo
González,Gilberto
author_sort Domínguez,José Miguel
title Utilidad de la PTH intraoperatoria como predictor de curación quirúrgica en hiperparatiroidismo primario
title_short Utilidad de la PTH intraoperatoria como predictor de curación quirúrgica en hiperparatiroidismo primario
title_full Utilidad de la PTH intraoperatoria como predictor de curación quirúrgica en hiperparatiroidismo primario
title_fullStr Utilidad de la PTH intraoperatoria como predictor de curación quirúrgica en hiperparatiroidismo primario
title_full_unstemmed Utilidad de la PTH intraoperatoria como predictor de curación quirúrgica en hiperparatiroidismo primario
title_sort utilidad de la pth intraoperatoria como predictor de curación quirúrgica en hiperparatiroidismo primario
publisher Sociedad Médica de Santiago
publishDate 2009
url http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872009001200007
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