Blood parathormon and calcium changes after total thyroidectomy and concurrent parathyroid autotransplantation
Metin Serin, Türkay Kirdak, Halit Ziya Dundar, Serkan Ceylan, Barış Candan, Nazım Serhat Parlak, Nusret Korun
Uludağ Üniversitesi, Tıp Fakültesi, Genel Cerrahi Kliniği, Bursa
Keywords: Thyroidectomy, parathyroid autotransplantation, hypocalcemia, parathormone, calcium, percent change
Aim: Many studies related with parathyroid autotransplantation are more likely to include data about the number of cases with transient and permanent hypocalcemia. Changes occured in blood parathormone (PTH) and calcium (Ca+2) values during early postoperative period are not sufficiently included. In the present study, changes of blood PTH and Ca+2 values in patients underwent concurrent total thyroidectomy and parathyroid autotransplantation; during early postoperative period were evaluated.
Materials and methods: Blood PTH and Ca+2 values of 39 consecutive patients underwent concurrent total thyroidectomy and parathyroid autotransplantation at the postoperative 6-12th hours, first day, between 1-4th weeks and sixth month were retrospectively evaluated. Median Percentage (%) Changes (PC) of subsequent measurements based on the first postoperative PTH and Ca 2+ values between 6-12 hours were examined. In addition, the effect of age, presence of cancer and body mass index on the results of parathyroid autotransplantation were evaluated.
Results: Median blood PTH and median Ca+2 levels of 39 cases underwent concurrent total thyroidectomy and parathyroid autotransplantation at the first postoperative 6-12 hours were 9.9 ng/mL and 8.1 mg/dl; respectively. Based on these results, it was observed that median PC values of blood PTH at the postoperative first day did not change significantly whereas median PC values of blood Ca+2 still tended to decrease. However; it was observed that median PC values of PTH and Ca+2 at 1-4th weeks and sixth month were changed towards increasing. There were 2 (%5) cases of permanent hypoparathyroidism.
Conclusion: Considerable changes in blood PTH and Ca+2 values during early postoperative period occur in cases underwent parathyroid autotransplantation during total thyroidectomy. However; relationship between these changes in PTH and Ca+2 values and effecs of other factors are still controversial.