Intraoperative parathyroid hormone assay during surgery for secondary hyperparathyroidism: is it time to give up the chase at the hormone?

摘要

In the early 1990s, when George Irvin reported his first results about the use of a quick intraoperative parathyroid hormone assay (ioPTHa) during surgery for primary hyperparathyroidism (PHPT), this innovative instrument appeared to be an extremely promising way to provide surgeons with reliable guidance while performing a para-thyroidectomy for PHPT. In fact, the method had an acceptable certainty of confirming in most patients that all of the hyperfunctioning parathyroid tissue in the neck had been removed, to the extent of defining it as a "biochemical frozen section." Some of the limits of the technique became evident quite soon, because a limited but significant number of false-positive and false-negative results seemed to be unavoidable in every series that was reported, adding some uncertainty about the real effectiveness of the tool .