Intraoperative Parathyroid Hormone Level as a Predictor of Post-Thyroidectomy Hyproparathyrodism

• Authors: Michał Lewandowicz , Krzysztof Kuzdak , Zbigniew Pasieka
• Languages of publication: EN

Abstracts

EN

Hypoparathyroidism is the most common complication of thyroid surgery. Accurate treatment of this condition requires early diagnosis of patients at risk of hypocalcemia.The aim of the study was to evaluate the predictive value of intraoperative parathyroid hormone assessment in identification of affected subjects.Material and methods. Sixty five subjects participated in the prospective study. They underwent bilateral neck exploration with subtotal or total thyroidectomy. Parathormone (PTH) and calcium levels were assessed prior to surgery, intraoperatively and at different time-points following the operation.Results. In respect of the results, patients were allocated into 3 groups: (A) subjects with asymptomatic course; (B) subjects with perioperative symptomatic hypocalcemia; (C) subjects with prolonged symptomatic hypocalcemia. No differences between these groups were observed in the intraoperative calcium levels. Intraoperative parathormone (ioPTH) level was significantly lower in group C and at value minor of the reference range identified group C subjects with sensitivity and specificity of 100 and 91.5%, respectively. Mean intraoperative PTH level decrease (ΔioPTH) of 22.5% was observed. ΔioPTH rate was significantly higher (81.4%) in group C. This parameter presented sensitivity of 66.7% and specificity of 93.2% in identification of group C patients.Conclusions. Single intraoperative PTH level assessment identifies subjects at risk of postoperative hypoparathyroidism. Intraoperative drop of PTH (ΔioPTH) proves less sensitive. Intraoperative calcium levels cannot be regarded as a predictor of this complication.

Keywords

EN

parathormone; intraoperative assessment; thyroidectomy; hypoparathyroidism; parathyroid autotransplantation

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2009
• Volume: 81
• Issue: 8
• Pages: 340-347

Dates

published

1 - 8 - 2009

online

22 - 10 - 2010

Contributors

author

Michał Lewandowicz

• Department of Endocrine and General Surgery, Medical University in Łódź

author

Krzysztof Kuzdak

• Department of Endocrine and General Surgery, Medical University in Łódź

author

Zbigniew Pasieka

• Department of Experimental Surgery, Chair of Endocrinology, Medical University in Łódź

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Identifiers

DOI

10.2478/v10035-009-0057-2