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Can Parathormon Levels after Ipsilateral Lobectomy Predict Postoperative Hypocalcemia in Patients Undergoing Total Thyroidectomy?

Abstract The purpose of this study was to investigate the relationship between the serum parathormone (PTH) levels measured after completion of hemithyroidectomy on the first side during total thyroidectomy and the postoperative hypocalcemia. The patients were divided into two groups, as those who demonstrated a decrease in PTH levels measured after completion of hemithyroidectomy of the first side (Group 1, n = 43) and those who did not demonstrate a decrease in PTH levels (Group 2, n = 24). The serum PTH levels were measured just before the incision (PTHi), when the hemithyroidectomy stage had been completed (PTHht), at the end of the operation (PTHtt), and at the postoperative 24th hour (PTH24hr). The serum total calcium (Ca2+) levels were also measured. The median percentage differences in PTHtt levels based on basal PTHi levels of Groups 1 and 2 were -60.6 and -15.7 per cent, respectively, P = 0.001. The frequency of postoperative biochemical hypocalcemia was higher in Group 1, P < 0.05. It was determined that a 10 per cent or higher decrease in PTHht levels in Group 1 could predict biochemical hypocalcemia at the postoperative 24th hour. In conclusions, postoperative hypocalcemia is seen more frequent in patients with a decrease of PTHht during total thyroidectomy. A decrease of 10 per cent in PTHht levels measured after ipsilateral lobectomy and a 62 per cent or higher decrease in PTHtt levels measured in the end of the total thyroidectomy could be helpful for prediction of postoperative hypocalcemia in these patients.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the american surgeon
Publication Year Start




PMID- 28424141
OWN - NLM
STAT- MEDLINE
DA  - 20170420
DCOM- 20170501
LR  - 20170501
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 83
IP  - 4
DP  - 2017 Apr 01
TI  - Can Parathormon Levels after Ipsilateral Lobectomy Predict Postoperative
      Hypocalcemia in Patients Undergoing Total Thyroidectomy?
PG  - 421-427
AB  - The purpose of this study was to investigate the relationship between the serum
      parathormone (PTH) levels measured after completion of hemithyroidectomy on the
      first side during total thyroidectomy and the postoperative hypocalcemia. The
      patients were divided into two groups, as those who demonstrated a decrease in
      PTH levels measured after completion of hemithyroidectomy of the first side
      (Group 1, n = 43) and those who did not demonstrate a decrease in PTH levels
      (Group 2, n = 24). The serum PTH levels were measured just before the incision
      (PTHi), when the hemithyroidectomy stage had been completed (PTHht), at the end
      of the operation (PTHtt), and at the postoperative 24th hour (PTH24hr). The serum
      total calcium (Ca2+) levels were also measured. The median percentage differences
      in PTHtt levels based on basal PTHi levels of Groups 1 and 2 were -60.6 and -15.7
      per cent, respectively, P = 0.001. The frequency of postoperative biochemical
      hypocalcemia was higher in Group 1, P &lt; 0.05. It was determined that a 10 per
      cent or higher decrease in PTHht levels in Group 1 could predict biochemical
      hypocalcemia at the postoperative 24th hour. In conclusions, postoperative
      hypocalcemia is seen more frequent in patients with a decrease of PTHht during
      total thyroidectomy. A decrease of 10 per cent in PTHht levels measured after
      ipsilateral lobectomy and a 62 per cent or higher decrease in PTHtt levels
      measured in the end of the total thyroidectomy could be helpful for prediction of
      postoperative hypocalcemia in these patients.
FAU - Kul, Fatih
AU  - Kul F
FAU - Kirdak, Turkay
AU  - Kirdak T
FAU - Sarkut, Pinar
AU  - Sarkut P
FAU - Ocakoglu, Gokhan
AU  - Ocakoglu G
FAU - Korun, Nusret
AU  - Korun N
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
RN  - 0 (Parathyroid Hormone)
RN  - SY7Q814VUP (Calcium)
SB  - IM
MH  - Calcium/blood
MH  - Female
MH  - Goiter/*surgery
MH  - Humans
MH  - Hypocalcemia/*blood
MH  - Male
MH  - Middle Aged
MH  - Parathyroid Hormone/*blood
MH  - Postoperative Complications/*blood
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Thyroidectomy/*methods
MH  - Treatment Outcome
EDAT- 2017/04/21 06:00
MHDA- 2017/05/02 06:00
CRDT- 2017/04/21 06:00
PST - ppublish
SO  - Am Surg. 2017 Apr 1;83(4):421-427.

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