Laterality of central venous sampling: lack of effect on the accuracy of intraoperative parathyroid hormone monitoring

BACKGROUND: The purpose of this study was to determine if laterality of internal jugular vein (IJV) sampling affects the accuracy of intraoperative parathyroid hormone (PTH) monitoring during parathyroidectomy for primary hyperparathyroidism. METHODS: In this study, 109 patients underwent parathyroidectomy (82 with unilateral disease, 27 with multigland disease). PTH samples were taken from both the left and the right IJV at these time points: preincision (baseline) and then at 5, 10, and, in selected patients, 20 minutes after excision. The Miami criterion was used to determine operative success. RESULTS: In all 109 patients combined, the mean decreases in intraoperative PTH levels were 73.8 +/- 22.2% for the left IJV and 71.9 +/- 23.0% for the right IJV (P = .22). The Miami criterion was met in 105 patients: in 100 (95%) left IJV samples and 99 (94%) right IJV samples (P = 1.00). CONCLUSIONS: No difference was found in the accuracy of intraoperative PTH monitoring between patients' left and right IJV samples. Central venous laterality did not affect fulfillment of the Miami criterion. (C) 2013 Elsevier Inc. All rights reserved.