Courtney M Edwards1, Jessica Folek2, Samantha Dayawansa1, Cara M Govednik3, Courtney E Quinn4, Benjamin R Sigmond5, Cortney Y Lee6, Melissa S Angel1, John C Hendricks1, Terry C Lairmore7. 1. Divsion of Surgical Oncology, Department of Surgery, Baylor Scott & White Health, Texas A&M University Health Science Center, 2401 S. 31st Street, Temple, TX 76508, USA. 2. St. Peter's Health Partners Medical Associates, Albany, NY, USA. 3. Department of Surgery, Baylor Scott and White Hillcrest Medical Center, Waco, TX, USA. 4. Yale Endocrine Surgery, Yale School of Medicine, New Haven, CT, USA. 5. The Ohio State University, OSU Hospitals East, Wexner Medical Center, Columbus, OH, USA. 6. Department of Surgery, University of Kentucky Health Care, Lexington, KY, USA. 7. Divsion of Surgical Oncology, Department of Surgery, Baylor Scott & White Health, Texas A&M University Health Science Center, 2401 S. 31st Street, Temple, TX 76508, USA. Electronic address: Terry.Lairmore@BSWHealth.org.
Abstract
BACKGROUND: Measurement of intraoperative parathyroid hormone (PTH) levels is an important adjunct to confirm biochemical cure during parathyroidectomy. The purpose of this study was to evaluate a simplified anatomic technique for PTH sampling from the central veins through the minimally invasive neck incision, and to compare the predictive accuracy of central and peripheral PTH values. METHODS: A specific anatomic method for central PTH sampling was employed in 48 patients. Samples were drawn simultaneously from peripheral and central veins at baseline and 10 minutes postexcision of all hyperfunctioning parathyroid glands. RESULTS: The central venous PTH levels independently predicted biochemical cure according to the Miami criterion in all the patients. There was no significant difference in the postexcision central and peripheral values, which were 24.40 + 1.86 and 21.69 + 1.74, respectively (P = .877, ANOVA test). CONCLUSIONS: This study provides the original description of a simplified technique for measurement of intraoperative PTH levels in the central veins with direct comparison to peripheral venous levels, and confirmation of accuracy in predicting biochemical cure when relying on centrally obtained values alone. Copyright Â
BACKGROUND: Measurement of intraoperative parathyroid hormone (PTH) levels is an important adjunct to confirm biochemical cure during parathyroidectomy. The purpose of this study was to evaluate a simplified anatomic technique for PTH sampling from the central veins through the minimally invasive neck incision, and to compare the predictive accuracy of central and peripheral PTH values. METHODS: A specific anatomic method for central PTH sampling was employed in 48 patients. Samples were drawn simultaneously from peripheral and central veins at baseline and 10 minutes postexcision of all hyperfunctioning parathyroid glands. RESULTS: The central venous PTH levels independently predicted biochemical cure according to the Miami criterion in all the patients. There was no significant difference in the postexcision central and peripheral values, which were 24.40 + 1.86 and 21.69 + 1.74, respectively (P = .877, ANOVA test). CONCLUSIONS: This study provides the original description of a simplified technique for measurement of intraoperative PTH levels in the central veins with direct comparison to peripheral venous levels, and confirmation of accuracy in predicting biochemical cure when relying on centrally obtained values alone. Copyright Â