With the development of imaging and localization studies,focused parathyroidectomy with use of intraope-rative parathormone monitoring(IPM)is the mainstay of treatment for primary hyperparathyroidism at many health ca...With the development of imaging and localization studies,focused parathyroidectomy with use of intraope-rative parathormone monitoring(IPM)is the mainstay of treatment for primary hyperparathyroidism at many health care centers both nationally and internationally.Focused parathyroidectomy guided by IPM allows for surgical excision of the offending parathyroid gland through smaller incisions.The Miami criterion is a protocol that uses a">50%parathormone(PTH)drop"from either the greatest pre-incision or pre-excision measurement of PTH in a blood sample taken 10 min following resection of hyperfunctioning glands.Following removal of the hyperfunctioning parathyroid gland,a>50%PTH drop at 10 min indicates completion of parathyroidectomy,and predicts operative success at6 mo.IPM using the Miami criterion has demonstrated equal curative rates of>97%,which is comparable to the traditional bilateral neck exploration.The focused approach,however,is associated with shorter recovery times,improved cosmesis,and lower risk of postoperative hypocalcemia.展开更多
文摘With the development of imaging and localization studies,focused parathyroidectomy with use of intraope-rative parathormone monitoring(IPM)is the mainstay of treatment for primary hyperparathyroidism at many health care centers both nationally and internationally.Focused parathyroidectomy guided by IPM allows for surgical excision of the offending parathyroid gland through smaller incisions.The Miami criterion is a protocol that uses a">50%parathormone(PTH)drop"from either the greatest pre-incision or pre-excision measurement of PTH in a blood sample taken 10 min following resection of hyperfunctioning glands.Following removal of the hyperfunctioning parathyroid gland,a>50%PTH drop at 10 min indicates completion of parathyroidectomy,and predicts operative success at6 mo.IPM using the Miami criterion has demonstrated equal curative rates of>97%,which is comparable to the traditional bilateral neck exploration.The focused approach,however,is associated with shorter recovery times,improved cosmesis,and lower risk of postoperative hypocalcemia.
