{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T15:05:43Z","timestamp":1770822343743,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2005,5,19]],"date-time":"2005-05-19T00:00:00Z","timestamp":1116460800000},"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":[[2005,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Rapid intraoperative parathyroid hormone (RIOPTH) monitoring predicts complete removal of all hypersecreting tissue by means of a significant parathyroid hormone (PTH) decrease. In this study we have tried to provide an explanation for some unexpected results of RIOPTH monitoring observed during a series of 125 conventional parathyroidectomies for primary hyperthyroidism, discussing the possible consequences on the surgical strategy. Three main groups can be recognized: (1) spikes: a PTH increase 10\u00a0minutes after removal of the diseased gland was observed in three patients; (2) false\u2010negative results: six patients showed an inadequate PTH decreases at 10\u00a0minutes, three of them resulting in cure at 20\u00a0minutes (all six patients were cured at follow\u2010up); (3) false\u2010positive results: five patients with multiglandular disease showed a PTH decrease to a cure level despite excision of one adenoma only (in two of these patients a 20\u2010minute sample showed a PTH increase soon after manipulation of the second adenoma). We concluded that the spike, almost certainly a consequence of manipulating the adenoma, when detected should be considered the \u201ctrue\u201d baseline value. False\u2010negative results are to some extent related to undetected spikes. The assay used for RIOPTH determination and PTH half\u2010life variability may also play a role. A false\u2010negative result usually prolongs the surgical time. False\u2010positive results are usually related to a double adenoma, one functionally prevailing over the other. Because in our experience manipulation of the second adenoma brought a PTH increase detected with RIOPTH monitoring, we believe that the second adenoma should be excised.<\/jats:p>","DOI":"10.1007\/s00268-005-7751-y","type":"journal-article","created":{"date-parts":[[2005,5,11]],"date-time":"2005-05-11T08:42:42Z","timestamp":1115800962000},"page":"785-788","source":"Crossref","is-referenced-by-count":16,"title":["Unexpected Results Using Rapid Intraoperative Parathyroid Hormone Monitoring during Parathyroidectomy for Primary Hyperparathyroidism"],"prefix":"10.1002","volume":"29","author":[{"given":"Ignazio","family":"Emmolo","sequence":"first","affiliation":[{"name":"General Surgery Division Santa Croce e Carle Hospital Via M. Coppino 26 12100 Cuneo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert Dal","family":"Corso","sequence":"additional","affiliation":[{"name":"General Surgery Division Santa Croce e Carle Hospital Via M. Coppino 26 12100 Cuneo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Borretta","sequence":"additional","affiliation":[{"name":"Endocrinology Division Santa Croce e Carle Hospital Via M. Coppino 26 12100 Cuneo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Visconti","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Chemistry Santa Croce e Carle Hospital Via M. Coppino 26 12100 Cuneo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Piovesan","sequence":"additional","affiliation":[{"name":"Oncological Endocrinology San Giovanni Battista Hospital Corso Bramante 88\/90 10126 Torino Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flora","family":"Cesario","sequence":"additional","affiliation":[{"name":"Endocrinology Division Santa Croce e Carle Hospital Via M. Coppino 26 12100 Cuneo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felice","family":"Borghi","sequence":"additional","affiliation":[{"name":"General Surgery Division Santa Croce e Carle Hospital Via M. 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