갑상선유두암에서 갑상선전절제술과 중심경부림프절절제술 후 발생하는 저칼슘혈증 예측 인자 연구

김형철; 정재홍; 최규성; 한선욱; 정준철; 조규석; 김지선; 허성모; 임철완; 정귀애; 이옥주; 신응진

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자료유형: 학술저널

저자정보: 김형철 정재홍 최규성 한선욱 정준철 조규석 김지선 허성모 임철완 정귀애 이옥주 신응진

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제15권 제3호

발행연도: 2015.1

수록면: 60 - 66 (7page)

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Purpose: Total thyroidectomy with central lymph node dissection (CLND) is a treatment modality of choice for thyroid cancer. Hypocalcemia is the most common complication after total thyroidectomy. The aim of the current study was to determine the association between surgery-related clinical factors and postoperative hypocalcemia.Methods: A prospective analysis was performed for 101 patients who underwent total thyroidectomy with CLND for papillary cancer from June 2013 to June 2014. Correlation between clinicopathologic factors and postoperative hypocalcemia was analyzed.Results: Based on the postoperative day-2 calcium, 56 patients (55%) developed hypo-calcemia and 45 patients (45%) were normal. No significant differences in histopathologic (tumor size, tumor focality, histologic type, number of retrieved lymph nodes, metastatic lymph node, thyroiditis, retrieved parathyroid gland) findings were observed between the hypocalcemia group and normal calcium group. Mean value of the postoperative day-0 parathyroid hormone (PTH) was significantly lower in the hypocalcemia group (hypoca1cemiagroup: 14.3±9.4 pg/mL; normal group: 25.0±16.4 pg/mL; P＜0.001). In logistic regression analysis, postoperative PTH was a factor significantly affecting postoperative hypocalcemia (OR 0.93; CI: 0.90-0.97; P＜0.001). In ROC analysis, the cut-off value of PTH was 19.965 (sensitivity 79%, specificity 58%), and area under the curve (AUC) was 0.709 (95% CI: 0.607-0.811).Conclusion: Postoperative PTH was a factor predicting hypocalcemia after total thyroidectomy with CLND. Use of postoperative PTH as a screening tool for prediction of postoperative hypocalcemia would be useful in management of patients with hypocal-cemia.

#갑상선암 #갑상선전절제술 #저칼슘혈증 #부갑상선호르몬 #Thyroid cancer #Total thyroidectomy #Hypocalcemia #Parathyroid hormone

참고문헌 (25)

참고문헌 신청

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Ardito G / 2005 / A less invasive, selective, functional neck dissection for papillary thyroid carcinoma / Langenbecks Arch Surg 390 : 381 ~ 384

Barczy?ski M / 2010 / Five-year follow-up of a randomized clinical trial of total thyroidectomy versus Dunhill operation versus bilateral subtotal thyroidectomy for multinod

Chisholm EJ / 2009 / Systematic review and meta-analysis of the adverse effects of thyroidectomy combined with central neck dissection as compared with thyroidectomy alone /

Chow TL / 2001 / Outcomes and complications of thyroid surgery: retrospective study / Hong Kong Med J 7 : 261 ~ 265

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