title: The impact of thyroidectomy on parathyroid glands: a biochemical and clinical profile.
abstract: BACKGROUND
  An evaluation of PTH levels during thyroid surgery may reflect the functional status of the parathyroids and be useful in identifying patients at risk for hypocalcemia. This study aims to monitor the parathyroid function during total thyroidectomy through intra-operative serial samples for calcium and PTH.
  
  
  METHODS
  Forty-seven patients undergoing total thyroidectomy for different diseases were selected for the study. Patients underwent serum PTH and calcium sampling at the induction of anesthesia (T0) and after the first (T1) and the second (T2) lobectomy. Serum calcium was also drafted 24 h after the operation.
  
  
  RESULTS
  Mean PTH at T0, T1, and T2 was, respectively: 32.1 pg/ml, 19.6 pg/ml, and 11.5 pg/ml. PTH was significantly higher at T0 when compared to T1 (p<0.0001). It was also significantly higher at T1 than at T2 (p<0.0001). At T1 PTH levels were below the normal range in 20/47 cases (42.5%) and at T2 in 31/47 cases (66%). Twenty-four h after surgery, 8 patients (17%) demonstrated a biochemical hypocalcemia. A PTH value at T0 in the upper (>70 pg/ml) or in the lower (<20 pg/ml) limits of the normal range was statistically related to post-operative hypocalcemia (p=0.017).
  
  
  CONCLUSIONS
  The study seems to confirm that serum PTH during thyroidectomy does not represent a sensitive tool in precociously identifying hypocalcemic patients. Nevertheless, before surgery, a PTH concentration at the higher or lower normal limit may help to identify patients "at risk" of developing hypocalcemia.
authors.affiliation: Department of Surgery, University of Pisa, Via Roma 67, 56100, Pisa, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Miccoli
authors.forename: M N
authors.initials: MN
authors.lastname: Minuto
authors.forename: E
authors.initials: E
authors.lastname: Panicucci
authors.forename: F
authors.initials: F
authors.lastname: Cetani
authors.forename: J
authors.initials: J
authors.lastname: D'Agostino
authors.forename: E
authors.initials: E
authors.lastname: Vignali
authors.forename: A
authors.initials: A
authors.lastname: Picone
authors.forename: C
authors.initials: C
authors.lastname: Marcocci
authors.forename: P
authors.initials: P
authors.lastname: Berti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000502:physiology*; D010281:Parathyroid Hormone / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology*; D012307:Risk Factors; D013965:Thyroidectomy
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D002118:Calcium