Serum Intact Parathyroid Hormone Level After Total Thyroidectomy or Total Thyroidectomy Plus Lymph Node Dissection for Thyroid Nodules: Report From 296 Surgical Cases

authors:

avatar Yukiko Yano 1 , * , avatar Chie Masaki 1 , avatar Kiminori Sugino 1 , avatar Mitsuji Nagahama 1 , avatar Wataru Kitagawa 1 , avatar Hiroshi Sibuya 1 , avatar Koichi Ito 1

Ito Hospital, y-yano@itohospital.jp, Japan
International Journal of Endocrinology and Metabolism: Vol.10, issue 4; 594-598
published online: September 29, 2012
article type: Original Article
received: November 9, 2011
accepted: June 9, 2012
DOI: https://doi.org/10.5812/ijem.3462

how to cite: Yano Y, Masaki C, Sugino K, Nagahama M, Kitagawa W, et al. Serum Intact Parathyroid Hormone Level After Total Thyroidectomy or Total Thyroidectomy Plus Lymph Node Dissection for Thyroid Nodules: Report From 296 Surgical Cases. Int J Endocrinol Metab. 2012;10(4): 594-598. https://doi.org/10.5812/ijem.3462.

Abstract

Background:

Transient hypocalcemia is one of the postoperative complications of thyroidectomy for thyroid nodules, and intraoperative and postoperative intact parathyroid hormone (iPTH) assays are used to predict postoperative hypocalcemia.

Objectives:

The current study was conducted to evaluate a single serum iPTH measurement on postoperative day 1 (POD 1) as a means to predict hypocalcemia occurrence after total thyroidectomy (TT).

Patients and Methods:

The subjects consisted of 36 patients who underwent TT and 260 patients who underwent TT plus lymph node (LN) dissection for thyroid nodules treatment. The TT performance procedure to prevent postoperative hypoparathyroidism combines parathyroid gland preservation in situ with autotransplantation of resected or devascularized parathyroid glands. The patients serum iPTH level was measured on POD 1, and their serum calcium level was measured on POD 1 and on POD 3 while they were still inpatients. The serum iPTH level was subequently measured at each outpatient clinic visit until it recovered to the normal range.

Results:

Hypoparathyroidism after TT and TT plus LN dissection was ultimately diagnosed in a total of 229 patients, and in 69 of them hypocalcemia was diagnosed on POD 1. All of the 69 patients diagnosed with hypocalcemia received calcium and vitamin D supplementation therapy. The serum iPTH level of 67 of 229 patients was within normal range on POD 1, and four of them developed hypocalcemia on POD 1. Permanent hypoparathyroidism developed in 37 of 296 patients after undergoing TT or TT plus LN dissection for thyroid nodules in the hospital.

Conclusions:

A single serum iPTH measurement on POD 1 is useful to determine whether or not to start calcium and vitamin D supplementation in order to maintain normocalcemia after surgery.

Full Text

Full text is available in PDF