The Variation of Parathyroid Hormone after Thyroidectomy and The Exploration of Influence Factors for Postthyroidectomy Hypocalcemia_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGWei-ming , WANGHai-nan , LIHe , LIANGJie-jia , XUWei-xue ,  XUJin

Department of Pancreatic and Thyroid Surgery, Affiliated Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China;

Corresponding?author：

XUJin, Email: xujinwang@163.com

Keywords：

Postthyroidectomy hypocalcemia; Parathyroid hormone; Thyroidectomy

DOI：

10.7507/1007-9424.20160377

Video：

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Objective To summarize the variation of parathyroid hormone (PTH) after thyroidectomy and the influence factors of postthyroidectomy hypocalcemia (PHC). Methods Clinical data of 95 patients who underwent thyroidectomy in Affiliated Shengjing Hospital of China Medical University from Jan. 2015 to Dec. 2015 were analyzed retrospectively. Results Of the 95 patients, there were 27 patient (28.42%) suffered from PHC (PHC group), and levels of serum calcium in the other 68 patients (71.58%) were normal (normal group). There was no significant difference in levels of serum calcium and PTH between the PHC group and normal group before operation (P > 0.05), but levels of serum calcium and PTH in PHC group were both lower than corresponding index of normal group after operation (P < 0.05). The levels of serum calcium and PTH both decreased in PHC group after operation (P < 0.05), and only PTH level decreased in normal group after operation (P < 0.05). PHC was related with type of operation, who underwent two-side operation had higher risk of PHC (P < 0.05), but there was no significant relationship between PHC and gender or age (P > 0.05). Conclusions PTH is an important factor for PHC. In addition, it is easier to occur PHC when the operative range become bigger.

Citation： ZHANGWei-ming, WANGHai-nan, LIHe, LIANGJie-jia, XUWei-xue, XUJin. The Variation of Parathyroid Hormone after Thyroidectomy and The Exploration of Influence Factors for Postthyroidectomy Hypocalcemia. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(12): 1496-1499. doi: 10.7507/1007-9424.20160377 Copy

1.	American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer; Cooper DS, Doherty GM, et al. Revised American thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid, 2009, 19(11):1167-1214.
2.	陳敏, 伍建春, 魏明輝.甲狀腺癌不同手術方式對術后甲狀旁腺功能和低鈣血癥的影響.臨床和實驗醫學雜志, 2015, 14(6):477-479.
3.	Pradeep PV, Ramalingam K. Postoperative PTH measurement is not a reliable predictor for hypocalcemia after total thyroidectomy in vitamin D deficiency:prospective study of 203 cases. World J Surg, 2014, 38(3):564-567.
4.	Del Rio P, Cataldo S, Pisani P, et al. Use of oxidized and regenerated cellulose in thyroid surgery:a prospective analysis as cause of postoperative hypocalcemia on 485 patients consecutively treated. Minerva Endocrinol, 2011, 36(3):157-162.
5.	孫榮昊, 李超, 樊晉川.外科手術初治分化型甲狀腺癌后主要并發癥及輔助治療研究進展.中華全科醫師雜志, 2013, 12(12):974-976.
6.	Lee YS, Nam KH, Chung WY, et al. Postoperative complications of thyroid cancer in a single center experience. J Korean Med Sci, 2010, 25(4):541-545.
7.	黃國平, 蔡銘智, 陳培臻.甲狀腺癌術后低鈣血癥探討.實用醫學雜志, 2009, 25(15):2501-2502.
8.	Docimo G, Tolone S, Pasquali D, et al. Role of pre and post-operative oral calcium and vitamin D supplements in prevention of hypocalcemia after total thyroidectomy. G Chir, 2012, 33(11-12):374-378.
9.	Rajinikanth J, Paul MJ, Abraham DT, et al. Surgical audit of inadvertent parathyroidectomy during total thyroidectomy:incidence, risk factors, and outcome. Medscape J Med, 2009, 11(1):29.
10.	Tredici P, Grosso E, Gibelli B, et al. Identification of patients at high risk for hypocalcemia after total thyroidectomy. Acta Otorhinolaryngol Ital, 2011, 31(3):144-148.
11.	Nemade SV, Chirmade AP. Post-thyroidectomy early serum ionic calcium level:predictor of prolonged hypocalcemia. Ear Nose Throat J, 2013, 92(8):382-390.
12.	來益, 費夢嘉, 王家東.不同甲狀腺手術方式對圍手術期血鈣濃度的影響.臨床耳鼻咽喉頭頸外科雜志, 2014, 28(23):1873-1876.
13.	Lindblom P, Westerdahl J, Bergenfelz A. Low parathyroid hormone levels after thyroid surgery:a feasible predictor of hypocalcemia. Surgery, 2002, 131(5):515-520.
14.	AlQahtani A, Parsyan A, Payne R, et al. Parathyroid hormone levels 1 hour after thyroidectomy:an early predictor of postoperative hypocalcemia. Can J Surg, 2014, 57(4):237-240.
15.	Rivere AE, Brooks AJ, Hayek GA, et al. Parathyroid hormone levels predict posttotal thyroidectomy hypoparathyroidism. Am Surg, 2014, 80(8):817-820.
16.	Warren FM, Andersen PE, Wax MK, et al. Intraoperative parathyroid hormone levels in thyroid and parathyroid surgery. Laryngoscope, 2002, 112(10):1866-1870.
17.	吳勝東, 高力, 葉學紅, 等.甲狀腺癌手術后低鈣血癥65例臨床分析.中國實用外科雜志, 2003, 23(3):158-160.
18.	Chapman DB, French CC, Leng X, et al. Parathyroid hormone early percent change:an individualized approach to predict postthyroidectomy hypocalcemia. Am J Otolaryngol, 2012, 33(2):216-220.
19.	Lang BH, Yih PC, Ng KK. A prospective evaluation of quick intrao-perative parathyroid hormone assay at the time of skin closure in predicting clinically relevant hypocalcemia after thyroidectomy. World J Surg, 2012, 36(6):1300-1306.
20.	Fahad Al-Dhahri S, Al-Ghonaim YA, Sulieman Terkawi A. Accuracy of postthyroidectomy parathyroid hormone and corrected calcium levels as early predictors of clinical hypocalcemia. J Otolaryngol Head Neck Surg, 2010, 39(4):342-348.
21.	徐德全, 代文杰.甲狀旁腺激素替代療法治療甲狀旁腺功能減退研究進展.中國實用外科雜志, 2014, 34(5):459-460.
22.	周廣起, 劉新梅, 熊斌, 等.分化型甲狀腺癌術后PTH變化及發生低鈣血癥的臨床分析.中國普通外科雜志, 2014, 23(5):700-702.
23.	Alhefdhi A, Mazeh H, Chen H. Role of postoperative vitamin D and/or calcium routine supplementation in preventing hypocalcemia after thyroidectomy:a systematic review and meta-analysis. Oncologist, 2013, 18(5):533-542.
24.	Sanabria A, Dominguez LC, Vega V, et al. Routine postoperative administration of vitamin D and calcium after total thyroidectomy:a meta-analysis. Int J Surg, 2011, 9(1):46-51.
25.	巴合提·卡力甫, 艾則孜·阿不都熱依木, 賽力克·馬高維亞, 等.超聲刀在甲狀腺切除術中應用效果的Meta分析.中國普通外科雜志, 2013, 22(5):601-607.
26.	Pisanu A, Podda M, Reccia I, et al. Systematic review with meta-analysis of prospective randomized trials comparing minimally invasive video-assisted thyroidectomy (MIVAT) and conventional thyroidectomy (CT). Langenbecks Arc Surg, 2013, 398(8):1057-1068.

1. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer; Cooper DS, Doherty GM, et al. Revised American thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid, 2009, 19(11):1167-1214.
2. 陳敏, 伍建春, 魏明輝.甲狀腺癌不同手術方式對術后甲狀旁腺功能和低鈣血癥的影響.臨床和實驗醫學雜志, 2015, 14(6):477-479.
3. Pradeep PV, Ramalingam K. Postoperative PTH measurement is not a reliable predictor for hypocalcemia after total thyroidectomy in vitamin D deficiency:prospective study of 203 cases. World J Surg, 2014, 38(3):564-567.
4. Del Rio P, Cataldo S, Pisani P, et al. Use of oxidized and regenerated cellulose in thyroid surgery:a prospective analysis as cause of postoperative hypocalcemia on 485 patients consecutively treated. Minerva Endocrinol, 2011, 36(3):157-162.
5. 孫榮昊, 李超, 樊晉川.外科手術初治分化型甲狀腺癌后主要并發癥及輔助治療研究進展.中華全科醫師雜志, 2013, 12(12):974-976.
6. Lee YS, Nam KH, Chung WY, et al. Postoperative complications of thyroid cancer in a single center experience. J Korean Med Sci, 2010, 25(4):541-545.
7. 黃國平, 蔡銘智, 陳培臻.甲狀腺癌術后低鈣血癥探討.實用醫學雜志, 2009, 25(15):2501-2502.
8. Docimo G, Tolone S, Pasquali D, et al. Role of pre and post-operative oral calcium and vitamin D supplements in prevention of hypocalcemia after total thyroidectomy. G Chir, 2012, 33(11-12):374-378.
9. Rajinikanth J, Paul MJ, Abraham DT, et al. Surgical audit of inadvertent parathyroidectomy during total thyroidectomy:incidence, risk factors, and outcome. Medscape J Med, 2009, 11(1):29.
10. Tredici P, Grosso E, Gibelli B, et al. Identification of patients at high risk for hypocalcemia after total thyroidectomy. Acta Otorhinolaryngol Ital, 2011, 31(3):144-148.
11. Nemade SV, Chirmade AP. Post-thyroidectomy early serum ionic calcium level:predictor of prolonged hypocalcemia. Ear Nose Throat J, 2013, 92(8):382-390.
12. 來益, 費夢嘉, 王家東.不同甲狀腺手術方式對圍手術期血鈣濃度的影響.臨床耳鼻咽喉頭頸外科雜志, 2014, 28(23):1873-1876.
13. Lindblom P, Westerdahl J, Bergenfelz A. Low parathyroid hormone levels after thyroid surgery:a feasible predictor of hypocalcemia. Surgery, 2002, 131(5):515-520.
14. AlQahtani A, Parsyan A, Payne R, et al. Parathyroid hormone levels 1 hour after thyroidectomy:an early predictor of postoperative hypocalcemia. Can J Surg, 2014, 57(4):237-240.
15. Rivere AE, Brooks AJ, Hayek GA, et al. Parathyroid hormone levels predict posttotal thyroidectomy hypoparathyroidism. Am Surg, 2014, 80(8):817-820.
16. Warren FM, Andersen PE, Wax MK, et al. Intraoperative parathyroid hormone levels in thyroid and parathyroid surgery. Laryngoscope, 2002, 112(10):1866-1870.
17. 吳勝東, 高力, 葉學紅, 等.甲狀腺癌手術后低鈣血癥65例臨床分析.中國實用外科雜志, 2003, 23(3):158-160.
18. Chapman DB, French CC, Leng X, et al. Parathyroid hormone early percent change:an individualized approach to predict postthyroidectomy hypocalcemia. Am J Otolaryngol, 2012, 33(2):216-220.
19. Lang BH, Yih PC, Ng KK. A prospective evaluation of quick intrao-perative parathyroid hormone assay at the time of skin closure in predicting clinically relevant hypocalcemia after thyroidectomy. World J Surg, 2012, 36(6):1300-1306.
20. Fahad Al-Dhahri S, Al-Ghonaim YA, Sulieman Terkawi A. Accuracy of postthyroidectomy parathyroid hormone and corrected calcium levels as early predictors of clinical hypocalcemia. J Otolaryngol Head Neck Surg, 2010, 39(4):342-348.
21. 徐德全, 代文杰.甲狀旁腺激素替代療法治療甲狀旁腺功能減退研究進展.中國實用外科雜志, 2014, 34(5):459-460.
22. 周廣起, 劉新梅, 熊斌, 等.分化型甲狀腺癌術后PTH變化及發生低鈣血癥的臨床分析.中國普通外科雜志, 2014, 23(5):700-702.
23. Alhefdhi A, Mazeh H, Chen H. Role of postoperative vitamin D and/or calcium routine supplementation in preventing hypocalcemia after thyroidectomy:a systematic review and meta-analysis. Oncologist, 2013, 18(5):533-542.
24. Sanabria A, Dominguez LC, Vega V, et al. Routine postoperative administration of vitamin D and calcium after total thyroidectomy:a meta-analysis. Int J Surg, 2011, 9(1):46-51.
25. 巴合提·卡力甫, 艾則孜·阿不都熱依木, 賽力克·馬高維亞, 等.超聲刀在甲狀腺切除術中應用效果的Meta分析.中國普通外科雜志, 2013, 22(5):601-607.
26. Pisanu A, Podda M, Reccia I, et al. Systematic review with meta-analysis of prospective randomized trials comparing minimally invasive video-assisted thyroidectomy (MIVAT) and conventional thyroidectomy (CT). Langenbecks Arc Surg, 2013, 398(8):1057-1068.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Variation of Parathyroid Hormone after Thyroidectomy and The Exploration of Influence Factors for Postthyroidectomy Hypocalcemia

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