Abstract:
BACKGROUND:Exact tissue identification during parathyroidectomy is essential to successfully cure hyperparathyroidism. PTH level determination from tissue aspirates has been advocated as a "biochemical frozen section" for parathyroid tissue identification. We investigated the sensitivity and specificity of this method in a large cohort of consecutive patients who underwent parathyroidectomy in a tertiary referral center. METHODS:PTH levels of 359 tissue aspirates were measured intraoperatively in 223 consecutive patients from March 2006 to December 2008. Suspected parathyroid and control tissues were aspirated with a standardized technique immediately after their excision. Samples were processed for quick-PTH assay with peripheral blood samples before and after excision. PTH levels from tissue aspirates were correlated with pathological diagnosis. The Mann-Whitney test was used to determine statistical significance (P < 0.05). RESULTS:A total of 255 parathyroid (196 adenoma, 30 hyperplasia, 4 carcinoma, 25 normal parathyroid) and 104 nonparathyroid tissue (88 thyroid, 16 lymph node, thymus, or fat) aspirates were compared. A highly significant difference was found between PTH levels of parathyroid (8,120 +/- 2,711 pg/ml; interquartile range (IQR): 4,949-9,075) and nonparathyroid (0.8 +/- 9.29 pg/ml; IQR: 0.4-1.4) tissue aspirates (P < 0.005). This test is 100% sensitive and 100% specific to identify parathyroid tissue for values >84 pg/ml. Furthermore, PTH levels of pathological parathyroid aspirates (8,169 +/- 2,597; IQR: 5,634-9,109) were higher than that of normal parathyroid aspirates (4,130 +/- 2,952; IQR: 2,569-8,284; P = 0.0011). CONCLUSIONS:PTH level determination from tissue aspirates is a highly reliable, quick, and simple method to differentiate parathyroid and nonparathyroid tissues during parathyroidectomy. This method can obviate frozen sections in patients undergoing surgery for hyperparathyroidism.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Horányi J,Duffek L,Szlávik R,Takács I,Tóth M,Romics L Jrdoi
10.1007/s00268-009-0351-5subject
Has Abstractpub_date
2010-03-01 00:00:00pages
538-43issue
3eissn
0364-2313issn
1432-2323journal_volume
34pub_type
杂志文章abstract::This article presents an analysis of acute gastroduodenal mucosal lesions (AGML) based on a review of current literature and the personal experience of the authors. The pathology of AGML involes two distinct types of lesions, namely, superficial erosions confined to the acid-secreting gastric mucosa and presenting as ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01654729
更新日期:1977-01-01 00:00:00
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:There have been no reports on the impact of preoperative biliary MRSA infection on the outcome of major hepatectomy. The aim of this study was to review the surgical outcome of patients who underwent hepatobiliary resection after biliary drainage and to evaluate the impact of preoperative biliary MRSA infect...
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章
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pub_type: 杂志文章,meta分析,评审
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更新日期:2010-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2011-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00268-020-05648-2
更新日期:2020-09-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2015-02-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:2000-09-01 00:00:00
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pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 历史文章,杂志文章
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更新日期:2001-12-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2017-08-01 00:00:00
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journal_title:World journal of surgery
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更新日期:2002-06-01 00:00:00
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更新日期:2018-02-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2008-04-01 00:00:00