Percentage Decline of Parathyroid Hormone Level is a Predictor for Post-thyroidectomy Symptomatic Hypocalcemia

정다미; 김종규; 권형주; 임우성; 문병인

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자료유형: 학술저널

저자정보: 정다미 김종규 권형주 임우성 문병인

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제17권 제4호

발행연도: 2017.1

수록면: 168 - 174 (7page)

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Purpose: Postoperative hypocalcemia is one of the most common complications after thyroid surgery. However, the predictive efficacy of parathyroid hormone (PTH) level was still controversial. We investigated the cut-off value of perioperative PTH level for postoperative hypocalcemia after total thyroidectomy. Methods: Four hundred eighty-two patients performed total thyroidectomy from January 2015 to December 2016 were enrolled. Demographics, operative variables and the development of symptomatic hypocalcemia were collected and evaluated. Results: Transient symptomatic hypocalcemia occurred in 83 (17.2%) patients and 5 (1.0%) patients have progressed to the permanent hypocalcemia. Patients with transient symptomatic hypocalcemia showed significantly lower postoperative day 1 PTH level than those without hypocalcemia (7.7±6.5 vs. 13.1±10.4 pg/mL; P<0.001), while correlation between postoperative PTH level and development of symptomatic hypocalcemia was not found in a multivariate analysis (P=0.122). Percentage decline of the preoperative PTH only showed significant association with transient hypocalcemia and the recommended cut-off value was 75.0%. When percentage decline of 75.0% was used, the incidence of transient hypoparathyroidism was 3.4 times (95% confidence interval, 2.1–5.6) higher in high percentage decline group (P<0.001). In regard to the permanent hypoparathyroidism, there were no significant differences in all factors. Conclusion: Percentage decline of PTH can be used as a predictive factor for postoperative hypocalcemia. Cautions against preventing injury of the parathyroid glands with careful surgical technique should be recommended.

#Parathyroid hormone #Hypoparathyroidism #Thyroidectomy #Hypocalcemia #Sequelae

참고문헌 (25)

참고문헌 신청

Alia P / 2007 / Postresection parathyroid hormone and parathyroid hormone decline accurately predict hypocalcemia after thyroidectomy / Am J Clin Pathol 127 : 592 ~ 597

Asari R / 2008 / Hypoparathyroidism after total thyroidectomy: a prospective study / Arch Surg 143 : 132 ~ 137

Cannizzaro MA / 2017 / How to avoid and to manage post-operative complications in thyroid surgery / Updates Surg 69 : 211 ~ 215

Chia SH / 2006 / Prospective study of perioperative factors predicting hypocalcemia after thyroid and parathyroid surgery / Arch Otolaryngol Head Neck Surg 132 : 41 ~ 45

Del Rio P / 2005 / The utility of serum PTH assessment 24 hours after total thyroidectomy / Otolaryngol Head Neck Surg 132 : 584 ~ 586

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