PTH ASSAY IN THE FIRST POSTOPERATIVE DAY AFTER THYROIDECTOMY. EARLY PREDICTOR POSTOPERATIVE HYPOCALCEMIA?

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M. R. Pelizzo
A. Piotto
A. Toniato
C. Pagetta

Abstract

Background: The purpose of our study is to verify if PTH assay on the first postoperative day is a reliable early pre dictor of the onset of hypocalcemia.


Methods: Between October 1999 and May 2000, a pro spective trial involved 162 patients who underwent total or near total thyroidectomy at our institute. On the basis of PTH assay on first day we divided the patients in three groups: group A 28 patients with PTH <10 pg/ml; group B 34 patients with PTH between 10 and 16 pg/ml; group C 100 patients with PTH >16 pg/ml.


Results: In group A: 22 of 28 patients (78.5%) developed postoperative hypocalcemia and 20 (71.4%) needed repla cement therapy; in group B: 14 of 34 (41.1%) had posto perative hypocalcemia and 10 (29.4%) received treatment; in group C: 23 of 100 (23%) became hypocalcemic after surgery but only 5 (5%) require calcium-vitamin therapy. A statistically significant correlation (p=0.0017) was iden tified between post-operative PTH levels and lowest blood calcium values detected after surgery. The correlation between the drop in blood calcium levels after surgery and postoperative PTH (delta Ca) was sta tistically even more significant (p=0.0002); the lower the postoperative PTH, the higher the absolute value of the del ta Ca.


Conclusion: The authors suggest a clinical approach and pharmacological treatment protocol based on the outcome of PTH assay on the first post-operative day; a solution that is only apparently more costly because it in fact aims to ensure a more timely recourse to blood calcium monito ring or replacement therapy and also an earlier discharge of the patient.

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How to Cite
Pelizzo, M. R., et al. “PTH ASSAY IN THE FIRST POSTOPERATIVE DAY AFTER THYROIDECTOMY. EARLY PREDICTOR POSTOPERATIVE HYPOCALCEMIA?”. Annali Italiani Di Chirurgia, vol. 74, no. 5, Sept. 2003, pp. 511-5, https://annaliitalianidichirurgia.it/index.php/aic/article/view/3095.
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