Intraoperative parathormone measurements and postoperative hypocalcemia
| Autor: | Albert, Stepansky, Ruth, Gold-Deutch, Natan, Poluksht, Philippe, Hagag, Carlos, Benbassat, Anat, Mor, Dorit, Aharoni, Ilan, Wassermann, Zvi, Halpern, Ariel, Halevy |
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| Rok vydání: | 2010 |
| Předmět: |
Adenoma
Adult Aged 80 and over Male Parathyroidectomy Analysis of Variance Hypocalcemia Hyperparathyroidism Middle Aged Cohort Studies Intraoperative Period Young Adult Parathyroid Neoplasms Postoperative Complications Parathyroid Hormone Predictive Value of Tests Humans Female Aged Retrospective Studies |
| Zdroj: | The Israel Medical Association journal : IMAJ. 12(4) |
| ISSN: | 1565-1088 |
| Popis: | Hypocalcemia following thyroid and parathyroid surgery is a well-recognized potential complication.To determine the utility of intraoperative quick parathormone assay in predicting severe hypocalcemia development following parathyroidectomy for a single-gland adenoma causing primary hyperparathyroidism.A retrospective cohort study was performed. IO-QPTH values were measured at time 0 (T0) before incision, and 10 (T10) and 30 minutes (T30) following excision of the hyperfunctioning gland. Percent decrease in IO-QPTH at 10 minutes (T10), maximum percent decrease of IO-QPTH value, and lowest actual IO-QPTH value obtained at surgery were used to determine any correlation with the development of postoperative hypocalcemia requiring treatment.Percent decrease in IO-QPTH at 10 minutes, maximum percent decrease in IO-QPTH and lowest IO-QPTH value did not correlate with the lowest postoperative calcium levels measured 18 hours after surgery (r = 0.017, P = 0.860; r = 0.018, P = 0.850; and r = 0.002, P= 0.985 respectively). For the purposes of our analysis, patients were subdivided into three groups. Group 1 comprised 68 patients with normal calcium levels (serum Ca 8.6-10.3 mg/dl), group 2 had 28 patients with hypocalcemia (8.1-8.6 mg/dl), and group 3 included 12 patients with severe hypocalcemia (calcium levelor = 8.0 mg/dl) requiring calcium supplementation due to symptoms of hypocalcemia. There was no difference between the three groups in the lowest IO-QPTH value (P = 0.378), percent decrease in IO-QPTH (P = 0.305) and maximum percent dercrease in IO-QPTH (P = 0.142).IO-QPTH evaluation was not useful in predicting the group of patients susceptible to develop severe postoperative hypocalcemia. |
| Databáze: | OpenAIRE |
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