Document Detail

The impact of thyroidectomy on parathyroid glands: a biochemical and clinical profile.
MedLine Citation:
PMID:  17923798     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: An evaluation of PTH levels during thyroid surgery may reflect the functional status of the parathyroids and be useful in identifying patients at risk for hypocalcemia. This study aims to monitor the parathyroid function during total thyroidectomy through intra-operative serial samples for calcium and PTH. MATERIALS AND METHODS: Forty-seven patients undergoing total thyroidectomy for different diseases were selected for the study. Patients underwent serum PTH and calcium sampling at the induction of anesthesia (T0) and after the first (T1) and the second (T2) lobectomy. Serum calcium was also drafted 24 h after the operation. RESULTS: Mean PTH at T0, T1, and T2 was, respectively: 32.1 pg/ml, 19.6 pg/ml, and 11.5 pg/ml. PTH was significantly higher at T0 when compared to T1 (p<0.0001). It was also significantly higher at T1 than at T2 (p<0.0001). At T1 PTH levels were below the normal range in 20/47 cases (42.5%) and at T2 in 31/47 cases (66%). Twenty-four h after surgery, 8 patients (17%) demonstrated a biochemical hypocalcemia. A PTH value at T0 in the upper (>70 pg/ml) or in the lower (<20 pg/ml) limits of the normal range was statistically related to post-operative hypocalcemia (p=0.017). DISCUSSION: The study seems to confirm that serum PTH during thyroidectomy does not represent a sensitive tool in precociously identifying hypocalcemic patients. Nevertheless, before surgery, a PTH concentration at the higher or lower normal limit may help to identify patients "at risk" of developing hypocalcemia.
P Miccoli; M N Minuto; E Panicucci; F Cetani; J D'Agostino; E Vignali; A Picone; C Marcocci; P Berti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  30     ISSN:  1720-8386     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-10-09     Completed Date:  2007-10-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  666-71     Citation Subset:  IM    
Department of Surgery, University of Pisa, Via Roma 67, 56100, Pisa, Italy.
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MeSH Terms
Biological Markers
Calcium / blood
Hypocalcemia / blood,  epidemiology*
Middle Aged
Parathyroid Glands / physiology*
Parathyroid Hormone / blood*
Postoperative Complications / blood,  epidemiology*
Risk Factors
Reg. No./Substance:
0/Biological Markers; 0/Parathyroid Hormone; 7440-70-2/Calcium

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