Discover the tailored precision of intraoperative parathyroid hormone monitoring during total thyroidectomy, a game-changer for surgical outcomes and patient safety in thyroid procedures.
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An individual approach to intraoperative parathyroid hormone measurement during total thyroidectomy.
Vaiman et al., Am J Otolaryngol 2023
DOI: 10.1016/j.amjoto.2023.104159
Summary of Intraoperative PTH Testing for Predicting Hypocalcemia After Thyroidectomy
What’s New: This study explores the effectiveness of measuring intraoperative parathyroid hormone (PTH) levels immediately after thyroid gland removal to predict postoperative hypocalcemia, potentially allowing for early discharge and reduced post-operative testing.
Importance: Hypocalcemia is a frequent complication after thyroidectomy. Immediate PTH measurement could improve patient management and reduce hospital stay.
Contribution to Literature: The study suggests that a PTH decrease of ≥70% immediately after thyroid removal is a strong predictor of postoperative hypocalcemia, with 100% sensitivity and 82.9% specificity.
Results: Out of 63 patients, 11 developed hypocalcemia post-surgery. A ≥50% PTH decrease indicated that patients could be discharged early without hypocalcemia. A ≥70% decrease in PTH allowed for accurate treatment adjustments, preventing permanent hypocalcemia. The predictive values for a 70% PTH decrease were a positive predictive value (PPV) of 60.0% and a negative predictive value (NPV) of 100%.
Conclusion: Intraoperative PTH measurement can be done 1-2 minutes after thyroid removal, identifying patients who are not at risk for hypocalcemia and facilitating early discharge and reduced calcium monitoring.