ORIGINAL ARTICLES   

Chirurgia 2016 June;29(3):73-8

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Predictive value of parathormone level at skin closure for postoperative hypocalcemia

Havva N. ALPARSLAN YUMUN ¹, Mehmet F. EROL ², Kadir GULER ²

¹ Corlu State Hospital, Corlu, Turkey; ² Sevket Yilmaz Education Hospital, Bursa, Turkey

BACKGROUND: The development of hypocalcemia following thyroid surgery is a complication that prolongs the duration of hospitalization and necessitates long-term replacement treatment. Patients may even have permanent hypothyroidism. This study aims to investigate whether the parathormone level (PTH) measured at the skin closure is associated with the development of postoperative hypocalcemia.
METHODS: A total of 49 patients who underwent total thyroidectomy between January 2013 and March 2013 at the general surgery clinic of our hospital were included. Preoperative, perioperative, and postoperative variables were recorded. The PTH level was measured in each patient at the time of skin closure and the association between PTH level and postoperative hypocalcemia was evaluated.
RESULTS: The number of male and female patients was six (12.2%) and 43 (87.7%), respectively, while the mean age of the patients was 47.8 years (range: 24 to 89 years). During the postoperative follow-up, postoperative hypocalcemia developed in 15 patients (30.6%), whereas 34 patients were normocalcemic. The PTH level measured at the time of skin closure was significantly lower in patients with postoperative hypocalemia (P=0.001). The cut-off value of the PTH test for the development of postoperative hypocalcemia measured at the time of skin closure was calculated to be 15.45 pg/mL (P=0.003).
CONCLUSIONS: Our study results suggest that the measurement of PTH level at the time of skin closure is reliable and effective in the early diagnosis of hypocalcemia, which may develop following total thyroidectomy. The duration of hospitalization can be shortened using this test and, thus, postoperative complications of hypocalcemia can be avoided.