Document Type : Original Article
Authors
1 Assistant Professor of Surgery, Department of General Surgery, Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2 2. Assistant Professor of Thoracic Surgery, Department of Cardiovascular Surgery, Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
Introduction: The aim of this study was to determine the outcome of low PTH after surgery and to monitor parathyroid recovery times in patients who underwent total thyroidectomy. Material and Methods: A commercially available PTH (iPTH) test was used to monitor iPTH levels on days 1 and 4. PTH levels were negative. It is determined by the same blood test as the sCa level. To exclude vitamin D deficiency, we first measured 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels in all patients Postoperative hypoparathyroidism was defined as postoperative albumin-adjusted sCa levels below 1.9 mmol/L (Convert to mg/dL, divide) with 0.25 (range of use, 2.10-2.60 mmol/L) symptoms of hypocalcemia (response to neuromuscular stress including paresthesias, muscle spasms, tetany or seizures) or sCa levels lower than results (1.9-2.1 mmol/L) with neuromuscular symptoms during the first 4 days after surgery. Results: In a multivariate logistic regression model, we found that patients who received an autograft of parathyroid tissue during surgery were more likely to have low PTH immediately after surgery (OR = 2.6; 95% CI, 1.8-3.8). Additionally, patients with parathyroid tissue who showed negative parathyroid tissue removal on the final pathology report were more likely to have postoperative PTH <10 pg/mL (OR = 2.2; 95% CI, 1.5 -3.3). Parathyroid tissue was the only risk factor for permanent hypoparathyroidism in the pathology report (OR = 3.6, 95% CI, 1.1–11.5). Conclusion: This study suggests that drug therapy should be considered in addition to PTH measurement, as 50% of patients with persistent hypoparathyroidism have elevated PTH levels to ≥10 pg/mL, but still want more help to avoid hypoparathyroidism. Symptoms of calcemia. In addition, 12 months may be the most appropriate time to define persistent hypoparathyroidism, as 5% of patients with low PTH resolve 6-12 months after treatment.
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