Conclusions
Our approach with the PTH 20 minutes measurement when the value does not decrease significantly at 10 minutes made it possible to achieve a significant accuracy, sensitivity and specificity of the method avoiding unnecessary bilateral explorations and associated complications in patients undergoing minimally invasive surgery. Duration of surgery and related costs were only minimally increased.
Monitoring of the PTH decay appeared to be influenced by surgical manipulations during the more difficult adenoma preparation in minimally invasive parathyroidectomy.
The 20 minutes end-point seems to play a key role in the correct determination of surgical outcome, strongly improving the possibility of performing correct patient treatment.
So the 20 minutes PTH measurement appears very useful, avoiding unnecessary bilateral exploration and the related risk of complications with only a slight increase of the duration of surgery and its costs.