Importance of the intraoperative appearance of preserved parathyroid glands after total thyroidectomy. 2016

Tae-Yon Sung, and Yu-mi Lee, and Jong Ho Yoon, and Ki-Wook Chung, and Suck Joon Hong
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwan-gil, Songpa-Gu, Seoul, 138-736, Korea.

OBJECTIVE Hypocalcemia after total thyroidectomy is a concern for every endocrine surgeon. We conducted this study to establish the value of the macroscopic appearance of preserved parathyroid glands after thyroidectomy in predicting post-thyroidectomy hypocalcemia. METHODS In 2009, 237 patients underwent total thyroidectomy at our hospital. The macroscopic appearance of the preserved parathyroid glands was recorded and the serum calcium and intact parathyroid hormone levels were measured postoperatively. RESULTS Thirteen patients (5.5 %) had transient hypocalcemia and 1 patient (0.4 %) had permanent hypocalcemia. All of the hypocalcemia patients with more than one normal preserved parathyroid had asymptomatic transient hypocalcemia that did not require medication. The sensitivity, specificity, positive predictive value, and negative predictive value for hypocalcemia with at least 1 normal preserved parathyroid were 78.6, 79.4, 19.3, and 98.3 %, respectively. CONCLUSIONS The macroscopic appearance of preserved parathyroid glands and the number of well-preserved parathyroid glands after thyroidectomy proved effective in predicting post-thyroidectomy hypocalcemia.

UI MeSH Term Description Entries
D006996 Hypocalcemia Reduction of the blood calcium below normal. Manifestations include hyperactive deep tendon reflexes, Chvostek's sign, muscle and abdominal cramps, and carpopedal spasm. (Dorland, 27th ed) Hypocalcemias
D007432 Intraoperative Period The period during a surgical operation. Intraoperative Periods,Period, Intraoperative,Periods, Intraoperative
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010280 Parathyroid Glands Two pairs of small oval-shaped glands located in the front and the base of the NECK and adjacent to the two lobes of THYROID GLAND. They secrete PARATHYROID HORMONE that regulates the balance of CALCIUM; PHOSPHORUS; and MAGNESIUM in the body. Gland, Parathyroid,Glands, Parathyroid,Parathyroid Gland
D010281 Parathyroid Hormone A polypeptide hormone (84 amino acid residues) secreted by the PARATHYROID GLANDS which performs the essential role of maintaining intracellular CALCIUM levels in the body. Parathyroid hormone increases intracellular calcium by promoting the release of CALCIUM from BONE, increases the intestinal absorption of calcium, increases the renal tubular reabsorption of calcium, and increases the renal excretion of phosphates. Natpara,PTH (1-84),PTH(1-34),Parathormone,Parathyrin,Parathyroid Hormone (1-34),Parathyroid Hormone (1-84),Parathyroid Hormone Peptide (1-34),Hormone, Parathyroid
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D002118 Calcium A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. Coagulation Factor IV,Factor IV,Blood Coagulation Factor IV,Calcium-40,Calcium 40,Factor IV, Coagulation
D002277 Carcinoma A malignant neoplasm made up of epithelial cells tending to infiltrate the surrounding tissues and give rise to metastases. It is a histological type of neoplasm and not a synonym for "cancer." Carcinoma, Anaplastic,Carcinoma, Spindle-Cell,Carcinoma, Undifferentiated,Carcinomatosis,Epithelial Neoplasms, Malignant,Epithelioma,Epithelial Tumors, Malignant,Malignant Epithelial Neoplasms,Neoplasms, Malignant Epithelial,Anaplastic Carcinoma,Anaplastic Carcinomas,Carcinoma, Spindle Cell,Carcinomas,Carcinomatoses,Epithelial Neoplasm, Malignant,Epithelial Tumor, Malignant,Epitheliomas,Malignant Epithelial Neoplasm,Malignant Epithelial Tumor,Malignant Epithelial Tumors,Neoplasm, Malignant Epithelial,Spindle-Cell Carcinoma,Spindle-Cell Carcinomas,Tumor, Malignant Epithelial,Undifferentiated Carcinoma,Undifferentiated Carcinomas

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