PRELIMINARY SINGLE CENTER EXPERIENCE WITH AN INTRAOPERATIVE WHOLE BLOOD PTH ANALYZER

AUTHORS:
M. Arbogast (Cologne, Germany) , H. Alakus (Cologne, Germany) , C.J. Bruns (Cologne, Germany) , C. Chiapponi (Cologne, Germany)
Background:
Intraoperative PTH monitoring (IOPTH) is an established way of predicting cure from primary hyperparathyroidism (pHPT) during surgery but time-consuming. Therefore, there is a clinical need for time-sparing technologies. In 2022, an analyzer capable of measuring whole blood PTH in 5 minutes (NBCL Connect) was introduced in our operation theater. In the present study, we evaluate our preliminary experience.
Methods:
Retrospective data collection between 01.01.2022 and 30.11.2023 including 41 parathyroidectomies before (group A) and 41 after the introduction of NBCL Connect in our theater (group B).
Results:
Both groups included 13 male (31.7%) and 28 (68.3%) female patients, with 28 (68.3%) concordant, 11(26.8%) singular and no localization in 2 (4.8%) cases in group A, and 27 (65.8%) concordant, 10 (24.4%) singular and no localization in 4 (9.7%) cases in group B. In all group A parathyroidectomies PTH was not awaited, in all group B parathyroidectomies whole blood PTH at 10 minutes after resection was awaited. Both incision-to-suture (59.6 versus 57.2 minutes, p=0.39) and anesthesia-time (96.9 versus 89.5 minutes, p=0.22) did not significantly increase. In both groups, Calcium and PTH dropped adequately on day one and two. NBCL connect did not provide reliable results in three (7.3%) patients, in which cases lab results had to be awaited.
Conclusions:
The intraoperative whole blood PTH assessment with NBCL Connect did not increase surgical time in this preliminary test. Its utility in reoperative parathyroidectomy and non-concordant preoperative localization must be confirmed by further studies.