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Data are reported as mean \u00b1 SEM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 2HPT patients underwent 17 subtotal, 10 total, and 6 re\u2010exploratory parathyroidectomies, whereas the 3HPT patients underwent 54 subtotal, 15 limited, and 3 re\u2010exploratory parathyroidectomies. The percent decrease from the baseline ioPTH level at 5, 10, and 15\u00a0min after parathyroid resection, respectively, were 72% \u00b1 3%, 76% \u00b1 3%, and 76% \u00b1 3% in patients with 2HPT, and 52% \u00b1 6%, 60% \u00b1 4%, and 69% \u00b1 4% in patients with 3HPT. IoPTH levels failed to drop &gt;50% from baseline in 5 patients (2HPT: <jats:italic>n<\/jats:italic> = 2, 3HPT: <jats:italic>n<\/jats:italic> = 3) who were normocalcemic at last follow\u2010up. IoPTH did not alter the surgical approach in any 2HPT patients, but did alter management in 25% of 3HPT patients (15 limited resections and 3 supernumerary glands). Normocalcemia was achieved in 97% of 2HPT patients and 99% of 3HPT patients; 2 patients developed recurrent disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intraoperative PTH levels fell by &gt;50% in nearly 95% of patients with 2HPT and 3HPT, and the PTH level reliably predicted postoperative cure. Although the use of ioPTH did not alter surgical management in any patient with 2HPT, this rapid PTH assay affected the surgical care of a quarter of the patients with 3HPT, and it may prove to be a useful adjunct in this group of patients.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-010-0575-4","type":"journal-article","created":{"date-parts":[[2010,4,12]],"date-time":"2010-04-12T16:56:22Z","timestamp":1271091382000},"page":"1343-1349","source":"Crossref","is-referenced-by-count":41,"title":["Secondary and Tertiary Hyperparathyroidism: The Utility of ioPTH Monitoring"],"prefix":"10.1002","volume":"34","author":[{"given":"Susan C.","family":"Pitt","sequence":"first","affiliation":[{"name":"Department of Surgery, Section of Endocrine Surgery University of Wisconsin 600 Highland Avenue, Clinical Science Center H4\/722 53792\u20103284 Madison WI 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