Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Best Pract Res Clin Endocrinol Metab. 2019 Oct;33(5):101310. doi: 10.1016/j.beem.2019.101310. Epub 2019 Aug 8.
Intraoperative PTH monitoring (IOPTH) made minimally invasive parathyroidectomy in patients with primary HPT possible. However, with the increasing accuracy of preoperative localization studies there is a growing discussion if IOPTH is necessary in patients with localized single gland disease (concordant preoperative localization studies). Different interpretation criteria have been developed - each with their particular advantages and disadvantages, but the "perfect" criterion is still missing. Despite several pitfalls, which can be recognized intraoperatively and do not necessarily lead to a more extensive surgery, IOPTH seems to be a useful adjunct in surgery for PHPT. However, according to current guidelines, selected patients may be operated without IOPTH but need to be informed about the possibly increased risk of recurrent disease.
术中甲状旁腺激素监测 (IOPTH) 使原发性甲状旁腺功能亢进症的微创手术成为可能。然而，随着术前定位研究的准确性不断提高，对于术前定位研究一致的局限性单腺疾病患者，是否需要进行 IOPTH 检测的讨论也越来越多。已经制定了不同的解释标准——每个标准都有其特定的优点和缺点，但仍然缺乏“完美”的标准。尽管术中可以识别出一些陷阱，而且这些陷阱不一定会导致手术范围扩大，但 IOPTH 似乎是 PHPT 手术的有用辅助手段。然而，根据目前的指南，一些特定的患者可以在没有 IOPTH 的情况下进行手术，但需要告知他们疾病复发的风险可能会增加。
