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Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy
Published on: July 14, 2023
Parathyroid hormone assay predicts hypocalcaemia after total thyroidectomy
Mark S Sywak1, Fausto F Palazzo, Michael Yeh
1Department of Surgery, University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital, St Leonards, New South Wales, Australia. marksywak@nebsc.com.au
ANZ Journal of Surgery
|July 20, 2007
Summary
Early postoperative parathyroid hormone (PTH) measurement after total thyroidectomy (TT) reliably predicts hypocalcemia risk. A single PTH test at 4 hours post-surgery can identify at-risk patients, enabling early discharge.
Area of Science:
- Endocrinology
- Surgical Oncology
- Neurosurgery
Background:
- Traditional monitoring of parathyroid gland function post-total thyroidectomy (TT) relies on serum calcium levels.
- Assessing parathyroid hormone (PTH) levels offers a potential alternative for early risk stratification.
Purpose of the Study:
- To evaluate the accuracy of early postoperative parathyroid hormone (PTH) concentrations in predicting hypocalcemia after total thyroidectomy (TT).
Main Methods:
- A prospective cohort study involving 100 patients undergoing TT.
- Measurement of parathyroid hormone (PTH) preoperatively and at 4 and 23 hours postoperatively.
- Serum calcium levels monitored twice daily for 48 hours post-surgery.
Main Results:
- The incidence of temporary hypocalcemia (serum calcium < 2.0 mmol/L) was 18%.
- A parathyroid hormone (PTH) concentration of ≤3 ng/L at 4 hours post-surgery demonstrated high sensitivity (0.71) and specificity (0.94) for predicting hypocalcemia.
- The accuracy of a single 4-hour PTH measurement was high (AUC 0.90), with no significant difference compared to 23-hour measurements.
Conclusions:
- A single early postoperative parathyroid hormone (PTH) measurement after total thyroidectomy (TT) is a reliable predictor of hypocalcemia.
- This method can facilitate earlier patient discharge and potentially reduce the need for extensive postoperative monitoring.
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