Intraoperative rapid parathyroid hormone monitoring in parathyroid surgery

Intraoperative qPTH assay has become an important adjunct in modern parathyroid surgery. The use of preoperative sestamibi scan in combination with intraoperative qPTH in minimally invasive focused parathyroidectomy yields a success rate of at least 98%. This approach can decrease the length of hospital stay, and in many instances the procedure can be performed as outpatient surgery. Adding qPTH to sestamibi scan improves the success of parathyroidectomy. The small additional cost of qPTH seems to justify adding this assay to the armamentarium to obviate the need for re-operation, which significantly increases cost and risks of complications.