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Published in: Thyroid Research 1/2021

Open Access 01-12-2021 | Hemithyroidectomy | Research

Determination of calcium and parathyroid hormone levels following hemithyroidectomy

Authors: Isabel Fernández Palop, Cristina Fernández Martínez, María Jesús Segura Giménez, M. Carmen Azorin Samper, Rafael García Fuster

Published in: Thyroid Research | Issue 1/2021

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Abstract

Background and objective

Hypocalcemia is one of the main complications of thyroid surgery. We hypothesized that hemithyroidectomy may have an impact on serum parathyroid hormone (PTH) and calcium levels despite only one thyroid lobe is manipulated. The objective of this study was to analyze changes in serum PTH and calcium levels following hemithyroidectomy.

Methods

This is a prospective study of 53 patients who underwent thyroid lobectomy. The serum PTH level was determined in the preoperative period, 15 min after extraction of the surgical specimen, and 24 h and 3 weeks after surgery. Serum ionized calcium was also measured in the preoperative period and at 6 h, 24 h and 3 weeks after surgery. We assessed the postoperative calcium value and its relationship with the extent of fall in PTH levels in the postoperative period.

Results

None of the patients had the postoperative serum ionised calcium level less than 4 mg/dl. The decrease in postoperative calcium was statistically significant at 6 and 24 h after surgery; there was no difference at 3 weeks post-surgery. The change in post-operative serum PTH levels followed a similar trend to postoperative serum calcium levels.

Conclusions

Although serum calcium level decreased after a lobectomy, it always remained above 4 mg/dl. We conclude that hypocalcaemia is rare following hemithyroidectomy.
Literature
1.
go back to reference Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid Cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid Cancer. Thyroid. 2016;26(1):1–133 PubMed PMID: 26462967. Pubmed Central PMCID: 4739132.CrossRef Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid Cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid Cancer. Thyroid. 2016;26(1):1–133 PubMed PMID: 26462967. Pubmed Central PMCID: 4739132.CrossRef
2.
go back to reference Kumar R, Thompson JR. The regulation of parathyroid hormone secretion and synthesis. J Am Soc Nephrol. 2011;22(2):216–24 PubMed PMID: 21164021. Pubmed Central PMCID: 5546216.CrossRef Kumar R, Thompson JR. The regulation of parathyroid hormone secretion and synthesis. J Am Soc Nephrol. 2011;22(2):216–24 PubMed PMID: 21164021. Pubmed Central PMCID: 5546216.CrossRef
3.
go back to reference Pak CY. Calcium metabolism. J Am Coll Nutr. 1989;8(Suppl):46S–53S PubMed PMID: 2681327.CrossRef Pak CY. Calcium metabolism. J Am Coll Nutr. 1989;8(Suppl):46S–53S PubMed PMID: 2681327.CrossRef
4.
go back to reference Brown EM. Four-parameter model of the sigmoidal relationship between parathyroid hormone release and extracellular calcium concentration in normal and abnormal parathyroid tissue. J Clin Endocrinol Metab. 1983;56(3):572–81 PubMed PMID: 6822654.CrossRef Brown EM. Four-parameter model of the sigmoidal relationship between parathyroid hormone release and extracellular calcium concentration in normal and abnormal parathyroid tissue. J Clin Endocrinol Metab. 1983;56(3):572–81 PubMed PMID: 6822654.CrossRef
5.
go back to reference Testini M, Gurrado A, Lissidini G, Nacchiero M. Hypoparathyroidism after total thyroidectomy. Minerva Chir. 2007;62(5):409–15 PubMed PMID: 17947951.PubMed Testini M, Gurrado A, Lissidini G, Nacchiero M. Hypoparathyroidism after total thyroidectomy. Minerva Chir. 2007;62(5):409–15 PubMed PMID: 17947951.PubMed
6.
go back to reference Edafe O, Prasad P, Harrison BJ, Balasubramanian SP. Incidence and predictors of post-thyroidectomy hypocalcaemia in a tertiary endocrine surgical unit. Ann R Coll Surg Engl. 2014;96(3):219–23 PubMed PMID: 24780788. Pubmed Central PMCID: 4474053.CrossRef Edafe O, Prasad P, Harrison BJ, Balasubramanian SP. Incidence and predictors of post-thyroidectomy hypocalcaemia in a tertiary endocrine surgical unit. Ann R Coll Surg Engl. 2014;96(3):219–23 PubMed PMID: 24780788. Pubmed Central PMCID: 4474053.CrossRef
7.
go back to reference Pattou F, Combemale F, Fabre S, Carnaille B, Decoulx M, Wemeau JL, et al. Hypocalcemia following thyroid surgery: incidence and prediction of outcome. World J Surg. 1998;22(7):718–24 PubMed PMID: 9606288.CrossRef Pattou F, Combemale F, Fabre S, Carnaille B, Decoulx M, Wemeau JL, et al. Hypocalcemia following thyroid surgery: incidence and prediction of outcome. World J Surg. 1998;22(7):718–24 PubMed PMID: 9606288.CrossRef
8.
go back to reference Pelizzo MR, Bernante P, Toniato A, Piotto A, Grigoletto R. Hypoparathyroidism after thyroidectomy. Analysis of a consecutive, recent series. Minerva Chir. 1998;53(4):239–44 PubMed PMID: 9701977. Ipoparatiroidismo dopo tiroidectomia. Verifica di una serie consecutiva e recente.PubMed Pelizzo MR, Bernante P, Toniato A, Piotto A, Grigoletto R. Hypoparathyroidism after thyroidectomy. Analysis of a consecutive, recent series. Minerva Chir. 1998;53(4):239–44 PubMed PMID: 9701977. Ipoparatiroidismo dopo tiroidectomia. Verifica di una serie consecutiva e recente.PubMed
9.
go back to reference Wilson RB, Erskine C, Crowe PJ. Hypomagnesemia and hypocalcemia after thyroidectomy: prospective study. World J Surg. 2000;24(6):722–6 PubMed PMID: 10773126.CrossRef Wilson RB, Erskine C, Crowe PJ. Hypomagnesemia and hypocalcemia after thyroidectomy: prospective study. World J Surg. 2000;24(6):722–6 PubMed PMID: 10773126.CrossRef
10.
go back to reference Tartaglia F, Giuliani A, Sgueglia M, Patrizi G, Di Rocco G, Blasi S, et al. Is ionized calcium a reliable predictor of hypocalcemia after total thyroidectomy? A before and after study. Il Giornale di chirurgia. 2014;35(1–2):27–35 PubMed PMID: 24690338. Pubmed Central PMCID: 4321580.PubMedPubMedCentral Tartaglia F, Giuliani A, Sgueglia M, Patrizi G, Di Rocco G, Blasi S, et al. Is ionized calcium a reliable predictor of hypocalcemia after total thyroidectomy? A before and after study. Il Giornale di chirurgia. 2014;35(1–2):27–35 PubMed PMID: 24690338. Pubmed Central PMCID: 4321580.PubMedPubMedCentral
11.
go back to reference Thomusch O, Machens A, Sekulla C, Ukkat J, Brauckhoff M, Dralle H. The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surgery. 2003;133(2):180–5 PubMed PMID: 12605179.CrossRef Thomusch O, Machens A, Sekulla C, Ukkat J, Brauckhoff M, Dralle H. The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surgery. 2003;133(2):180–5 PubMed PMID: 12605179.CrossRef
12.
go back to reference Harding J, Sebag F, Sierra M, Palazzo FF, Henry JF. Thyroid surgery: postoperative hematoma--prevention and treatment. Langenbeck’s Arch Surg. 2006;391(3):169–73 PubMed PMID: 16555087.CrossRef Harding J, Sebag F, Sierra M, Palazzo FF, Henry JF. Thyroid surgery: postoperative hematoma--prevention and treatment. Langenbeck’s Arch Surg. 2006;391(3):169–73 PubMed PMID: 16555087.CrossRef
13.
go back to reference Edis AJ. Prevention and management of complications associated with thyroid and parathyroid surgery. Surg Clin North Am. 1979;59(1):83–92 PubMed PMID: 582079.CrossRef Edis AJ. Prevention and management of complications associated with thyroid and parathyroid surgery. Surg Clin North Am. 1979;59(1):83–92 PubMed PMID: 582079.CrossRef
Metadata
Title
Determination of calcium and parathyroid hormone levels following hemithyroidectomy
Authors
Isabel Fernández Palop
Cristina Fernández Martínez
María Jesús Segura Giménez
M. Carmen Azorin Samper
Rafael García Fuster
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Thyroid Research / Issue 1/2021
Electronic ISSN: 1756-6614
DOI
https://doi.org/10.1186/s13044-021-00104-2

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