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

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,. . .