{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T14:03:57Z","timestamp":1770559437765,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,11,20]],"date-time":"2013-11-20T00:00:00Z","timestamp":1384905600000},"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":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In minimally invasive surgery for primary hyperparathyroidism (HPT), intraoperative parathyroid hormone (IOPTH) monitoring assists in obtaining demonstrably better outcomes, but optimal criteria are controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The outcomes of 1,108\u00a0initial parathyroid operations for sporadic HPT using IOPTH monitoring from 1997 to 2011 were stratified by final post\u2010resection IOPTH level. All patients had adequate follow\u2010up to verify cure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>With mean follow\u2010up of 1.8 years (range 0.5\u201314.3 years), parathyroidectomy using IOPTH monitoring failed in 1.2 % of cases, with an additional 0.5 % incidence of long\u2010term recurrence at a mean of 3.2 years (range 0.8\u20136.8 years) postoperatively. Operative success was equally likely with a final IOPTH drop to 41\u201365 pg\/mL vs \u226440 pg\/mL (<jats:italic>p<\/jats:italic> = 1). In the 76 patients with an elevated baseline IOPTH level that did not drop to \u226465 pg\/mL, surgical failure was 43 times more likely than with a drop into normal range (13 vs. 0.3 %; <jats:italic>p<\/jats:italic> &lt; 0.001). When the final IOPTH level dropped by &gt;50 % but not into the normal range, surgical failure was 19 times more likely (3.8 vs. 0.2 %; <jats:italic>p<\/jats:italic> = 0.015). Long\u2010term recurrence was more likely in patients with a final IOPTH level of 41\u201365 pg\/mL than with a level \u226440 pg\/mL (1.2 vs. 0; <jats:italic>p<\/jats:italic> = 0.016).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adjunctive intraoperative PTH monitoring facilitates a high cure rate for initial surgery of sporadic primary hyperparathyroidism. A final IOPTH level that is within the normal range and drops by &gt;50 % from baseline is a strong predictor of operative success. Patients with a final IOPTH level between 41\u201365 pg\/mL should be followed beyond 6\u00a0months for long\u2010term recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-2329-6","type":"journal-article","created":{"date-parts":[[2013,11,19]],"date-time":"2013-11-19T16:48:34Z","timestamp":1384879714000},"page":"558-563","source":"Crossref","is-referenced-by-count":48,"title":["The Final Intraoperative Parathyroid Hormone Level: How Low Should It Go?"],"prefix":"10.1002","volume":"38","author":[{"given":"Laura I.","family":"Wharry","sequence":"first","affiliation":[{"name":"Division of Endocrine Surgery University of Pittsburgh 3471 Fifth Avenue, Kaufmann Building, Suite 101 15213 Pittsburgh PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linwah","family":"Yip","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery University of Pittsburgh 3471 Fifth Avenue, Kaufmann Building, Suite 101 15213 Pittsburgh PA 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