{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T08:41:58Z","timestamp":1762504918736},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2004,2,1]],"date-time":"2004-02-01T00:00:00Z","timestamp":1075593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2004,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Optimal interpretation of the results of intraoperative parathyroid hormone (IOPTH) monitoring during neck exploration for primary hyperparathyroidism (pHPT) is still controversial. The reliability of the \u201c50% rule\u201d in multiglandular disease (MGD) is often disputed, mostly because of competing pathophysiologic paradigms. The aim of this study was to ascertain and corroborate the ability of IOPTH monitoring to detect MGD in a practice, combining conventional and alternative parathyroid\u2010ectomy techniques. This is a retrospective single institution analysis of 69 consecutive patients undergoing cervical exploration for pHPT by various approaches. The IOPTH measurements were performed after induction of anesthesia but prior to skin incision and 10\u00a0minutes after excision of the first visualized enlarged parathyroid gland. In this series, 55 patients (80%) had single adenomas, and 14 patients (20%) had MGD. In 8 of the 14 patients with MGD, IOPTH levels were obtained sequentially after removal of every enlarged gland. Of these 8 patients, 6 (75%) had a false\u2010positive decrease (decrease below 50% of baseline value in presence of another enlarged gland) failing to predict the presence of a second enlarged gland. In 2 cases IOPTH monitoring provided a true\u2010negative result, correctly predicting MGD. If MGD is defined by gross morphologic criteria, IOPTH monitoring fails to predict the presence of MGD reliably. However, if MGD is defined by functional criteria, the course of these patients does not seem significantly affected. The importance of these findings must be further investigated, especially with regard to the outcome of minimally invasive parathyroid procedures.<\/jats:p>","DOI":"10.1007\/s00268-003-7255-6","type":"journal-article","created":{"date-parts":[[2004,3,3]],"date-time":"2004-03-03T22:35:10Z","timestamp":1078353310000},"page":"187-192","source":"Crossref","is-referenced-by-count":75,"title":["Impact of intraoperative parathyroid hormone monitoring on the prediction of multiglandular parathyroid disease"],"prefix":"10.1002","volume":"28","author":[{"given":"Thomas","family":"Clerici","sequence":"first","affiliation":[{"name":"Department of Surgery Kantonsspital St. Gallen CH\u20109007 St. Gallen Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Brandie","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes Department of Internal Medicine Kantonsspital St. Gallen CH\u20109007 St. Gallen Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Surgery Kantonsspital St. Gallen CH\u20109007 St. Gallen Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard M.","family":"Doherty","sequence":"additional","affiliation":[{"name":"General Surgery Division of Endocrine Surgery University of Michigan 48109\u20100331 Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul G.","family":"Gauger","sequence":"additional","affiliation":[{"name":"General Surgery Division of Endocrine Surgery University of Michigan 48109\u20100331 Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,2]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(05)80101\u20101"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199405000\u201000015"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039\u20106060(96)80040\u20107"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2099.101835"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2099.101833"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010200205000\u201000008"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03347996"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004649900634"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102168.1999.01295.x"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004230050207"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.136.7.810"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.136.5.536"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010002\u20106620\u20101"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.6.659"},{"key":"e_1_2_1_16_1","first-page":"1035","article-title":"Usefulness and limits of quick intraoperative measurements of intact (1\u201384) parathyroid hormone in the surgical management of hyperparathyroidism: sequential measurements in patients with multiglandular disease","volume":"110","author":"Proye CA","year":"1991","journal-title":"Surgery"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2001.118385"},{"key":"e_1_2_1_18_1","first-page":"723","article-title":"Multi\u2010glandular lesions in primary hyperparathyroidism. late outcome of 86 consecutive patients treated with conservative surgery","volume":"115","author":"Proye CA","year":"1989","journal-title":"Chirurgie"},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01665301"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02067373"},{"key":"e_1_2_1_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039\u20106060(96)80036\u20105"},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2099.101429"},{"key":"e_1_2_1_23_1","first-page":"260","article-title":"Therapeutischer Versuch bei einem Falle von Osteitis fibrosa generalisata mittels Exstirpation eines Epithelk\u00f6rperchentumors","volume":"5","author":"Mandl F","year":"1926","journal-title":"Zbl. Chir."},{"key":"e_1_2_1_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02791561"},{"key":"e_1_2_1_25_1","first-page":"466","article-title":"Conservative\u201d versus \u201cliberal\u201d approach to parathyroid neck exploration","volume":"82","author":"Edis AJ","year":"1977","journal-title":"Surgery"},{"key":"e_1_2_1_26_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2001.119112"},{"key":"e_1_2_1_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010001\u20100018\u20103"},{"key":"e_1_2_1_28_1","doi-asserted-by":"publisher","DOI":"10.1159\/000057949"},{"key":"e_1_2_1_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109343(79)90446\u20107"},{"key":"e_1_2_1_30_1","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2000.109964"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-003-7255-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-003-7255-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-003-7255-6","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T16:23:53Z","timestamp":1704990233000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-003-7255-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,2]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2004,2]]}},"alternative-id":["10.1007\/s00268-003-7255-6"],"URL":"https:\/\/doi.org\/10.1007\/s00268-003-7255-6","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,2]]}}}