Intraoperative Measurements of Urinary Cyclic Amp to Guide Surgery for Primary Hyperparathyroidism

Authors:
  • ASAllen M. Spiegel
    Allen M. Spiegel
  • SESarah T. Eastman
    Sarah T. Eastman
  • MAMaurice F. Attie
    Maurice F. Attie
  • RDRobert W. Downs
    Robert W. Downs
  • SMStephen J. Marx
    Stephen J. Marx
  • JSJohn L. Stock
    John L. Stock
  • ASAndrew W. Saxe
    Andrew W. Saxe
  • MBMurray F. Brennan
    Murray F. Brennan
  • GAGerald D. Aurbach
    Gerald D. Aurbach
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Abstract
SURGERY is the main form of therapy for primary hyperparathyroidism. The goal of therapy is to restore normal parathyroid function and avoid either persistent hyperfunction or permanent hypofunction. To achieve this goal the surgeon must remove an appropriate amount of hyperfunctioning tissue without injuring residual normal glands. At present the surgeon relies on gross and microscopical morphologic criteria in deciding which and how much parathyroid tissue to resect. Theoretically, intraoperative assessment of parathyroid function should help the surgeon to decide how much tissue to resect. We have previously shown1 that urinary cyclic AMP excretion, an accurate index of parathyroid function, . . .
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