Optimal use of intraoperative PTH levels in parathyroidectomy.

Objectives/hypothesis: Localization and the intraoperative parathyroid hormone assay (IOPTH) have facilitated minimally invasive parathyroidectomy. The precise algorithm governing use of IOPTH has been debated. Numerous authors advocate acquisition of a so-called pre-excision (P-E) baseline level (obtained after dissection of the adenoma, but prior to excision) in addition to a preincision baseline, to guard against spurious elevation in the baseline that might confuse interpretation of postexcision levels.

Value of sestamibi scans in tertiary hyperparathyroidism.

Objectives: To determine the value of preoperative Tc-sestamibi scans and the incidence of ectopic glands in tertiary hyperparathyroidism.

Design: Prospective, non-randomized analysis of a consecutive cohort of surgical patients from the Medical College of Georgia Thyroid/Parathyroid Center.

Materials And Methods: A consecutive series of patients with tertiary hyperparathyroidism undergoing parathyroidectomy was analyzed.