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Vol. 54. Issue 4.
Pages 273-276 (April 2003)
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Vol. 54. Issue 4.
Pages 273-276 (April 2003)
Valor de la determinación intraoperatoria de hormona paratiroidea en la cirugía del hiperparatiroidismo
Value of the intraoperative determination of parathyroid hormone (pth) in hyperparathyroidism surgery
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M.J. Ferrer Ramírez1
Corresponding author
mferrero@seorl.org

Correspondencia: Paseo Alameda, 38 Torre II, Piso 11, Pta 22. 46023 Valencia
, R. López martínez
Servicio de otorrinolaringología
A. López gutierrez*, M.J. Oliver Oliver*, I. Canós Llacer*
a Servicio de análisis clínicos. hospital universitario dr. peset. valencia
Article information
Resumen
Introducción

El éxito de la cirugía del hiperparatiroidismo se ha basado tradicionalmente en la exploración bilateral del cuello. La monitorización intraoperatoria de hormona paratiroidea intacta (PTHi), permite la confirmación bioquímica de que todo el tejido paratiroideo hiperfuncionante ha sido resecado, consiguiéndose cirugías menos extensas.

Material y métodos

Se obtuvieron muestras de sangre de 32 pacientes antes y 10 minutos después de la exéresis del tejido paratiroideo patológico. La monitorización de PTHi se llevó a cabo mediante inmunoquimioluminiscencia, con un tiempo de incubación corto y resultados disponibles en 15 minutos.

Resultados

Los niveles de PTHi descendieron > 60% en 30 de los 32 pacientes estudiados, 26 casos de adenoma y 4 casos de hiperplasia. Dos casos en los que la PTHi descendió <60% el diagnóstico fue de hiperplasia. los niveles de PTHi descendieron > 60% tras la exéresis de las glándulas hiperplásicas remanentes.

Conclusión

El análisis rápido de PTHi es una técnica fácil de realizar y es capaz de predecir el éxito de la cirugía del hiperparatiroidismo.

Palabras clave:
Hiperparatiroidismo
Cirugía
PTH intraoperatoria
Abstract
Introduction

The success in the surgical management of hyperparathyroidism has conventionally required a bilateral neck exploration. The intraoperative monitoring of intact parathyroid hormone (PTHi), allows a less extensive procedure by confirming the complete removal of hypersecreting tissue.

Methods

Plasma samples were obtained from 32 consecutive patients before and 10 minutes after removal of abnormal parathyroid tissue. PTH was measured with a modifie immunochemiluminometric assay with a short incubation time and the results made available in 15 minutes.

Results

PTHi decreased by at least 60% in 30 of 32 cases. A single adenoma was removed in 26 cases, and multiple hyperplastic glands in 4 cases. The two cases in which PTHi fell <60% were diagnosed as hyperplasia. PTHi decreased > 60% after the removal of the remnant hyperplastic glands.

Conclusions

The rapid PTHi assay had excellent analytical performance and predicted the success of parathyroid surgery.

Key words:
Hyperparathyroidism
Surgery
Intraoperative PTH assay

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