Document Detail

Applicability of intraoperative parathyroid hormone assay during thyroidectomy.
MedLine Citation:
PMID:  12409661     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the applicability of intraoperative parathyroid hormone (quick PTH) assay to monitor parathyroid function and to identify clinically significant hypocalcemia compared with postoperative serum calcium monitoring.
SUMMARY BACKGROUND DATA: Close monitoring of serum calcium levels is a standard of care to identify post-thyroidectomy hypocalcemia due to parathyroid insufficiency.
METHODS: Quick PTH assay was performed before and after thyroidectomy for 100 patients at risk of postoperative hypocalcemia and 20 control patients who underwent unilateral lobectomy. Postoperative serum calcium levels were closely monitored.
RESULTS: Control patients had a normal but 38.9 +/- 5.9% (mean +/- SEM) decline in quick PTH after thyroidectomy. Eleven of 100 at-risk patients (11%) developed postoperative hypocalcemia. Hypocalcemic patients had significantly lower quick PTH values after thyroidectomy compared with that of normocalcemic patients. Serum calcium was significantly lower in hypocalcemic patients the morning after operation but not early after the operation (within 6 hours). A normal or less than 75% decline in quick PTH after thyroidectomy can accurately identify normocalcemic patients during surgery as compared to more than 24 hours by serum calcium monitoring.
CONCLUSIONS: The quick PTH assay can monitor parathyroid function during thyroidectomy and identify patients at risk of clinically significant hypocalcemia much earlier than serum calcium monitoring. It may facilitate early discharge and the use of parathyroid autotransplantation during thyroidectomy.
Chung Yau Lo; John M Luk; Sidney C Tam
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  236     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-10-31     Completed Date:  2002-11-29     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  564-9     Citation Subset:  AIM; IM    
Department of Surgery and Division of Clinical Biochemistry, the University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
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MeSH Terms
Calcium / blood
Hypocalcemia / diagnosis,  etiology
Immunoradiometric Assay
Intraoperative Period
Luminescent Measurements
Middle Aged
Parathyroid Hormone / blood*
Thyroidectomy* / adverse effects
Reg. No./Substance:
0/Parathyroid Hormone; 7440-70-2/Calcium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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