A study on the role of perioperative parathormone level after total thyroidectomy as a predictor of hypocalcemia

INTRODUCTION: Thyroidectomy is the most common endocrine surgery performed. Hypocalcemia is one of the serious complication following Thyroidectomy, incidence varies from 20-30% occurs due to devascularisation or accidental removal of parathyroid gland. To manage postoperative hypocalcemia, most practitioners obtain serial serum calcium monitoringand respond appropriately to low levels. Recently, several studies have advocated measurement of the parathyroid hormone (PTH) level several hours after operation in order to predict the development of hypocalcemia. AIM OF THE STUDY: In this study we assess the role of Parathormone level after Total thyroidectomy in predicting the complication of hypocalcemia and to correlate the serum Parathormone and corrected calcium level after Thyroidectomy. METHODS: 48 patients admitted and underwent total thyroidectomy from January 2013 to December 2013 were included in this study. This study was approved by the ethical committee and informed consent was obtained from all participating patients. Serum calcium were measured before surgery. Postoperative parathormone and calcium were done and correlated following surgery. RESULTS: Total thyroidectomy was the procedure done in all 48 patients. 22 out of 48 patients (45.8%) mostly in the middle aged group developed postoperative hypocalcaemia, 18 patients (37.5%) had preoperative serum calcium less than 9.0g/dl. Low preoperative serum calcium significantly correlate with fall in post operative serum calcium. 16 patients had decreased post operative Intact PTH and all of them developed hypocalcemia suggesting a positive correlation between serum PTH and serum calcium done post operatively. CONCLUSION: Hypocalcemia following total thyroidectomy remains a significant cause of morbidity and increases the cost of procedure due to prolonged hospital stay. Use of serum PTH postoperatively 6hrs following total thyroidectomy significantly predict the complication of hypocalcemia. Proper identification of the parathyroid gland and preserving the gland with adequate vascularity significantly reduce the complication