title: [Avoidance and management of hypoparathyroidism after thyroid gland surgery].
abstract: Postoperative hypoparathyroidism after bilateral thyroid gland surgery or after interventions for recurrence is defined as intact parathyroid hormone levels (iPTH) < 15 pg/ml with simultaneous normal, below normal and markedly decreased serum calcium levels. After bilateral thyroid surgery and after reoperations a single iPTH measurement performed 12-24 h postoperatively can be used to predict parathyroid metabolism. Patients with an iPTH level ≥ 15 pg/ml may be discharged safely, patients with an iPTH < 10 pg/ml must be substituted with calcium and vitamin D and patients with an iPTH between 10 and 15 pg/ml (grey zone) may be discharged if a second measurement 48 h after surgery documents an iPTH ≥ 15 pg/ml. This procedure increases the length of hospital stay. Patients in the (grey zone) must be substituted. The iPTH level and its course determine the necessity, dose and length of calcium and vitamin D substitution.
authors.affiliation: Sektion "Chirurgische Endokrinologie", Abteilung für Allgemeinchirurgie, Universitätsklinik für Chirurgie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
authors.forename: A
authors.initials: A
authors.lastname: Selberherr
authors.forename: B
authors.initials: B
authors.lastname: Niederle
mesh_terms: D002118:Calcium / Q000097:blood / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D007011:Hypoparathyroidism / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control*; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010281:Parathyroid Hormone / Q000097:blood; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control*; D012016:Reference Values; D012086:Reoperation; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D014807:Vitamin D / Q000097:blood / Q000627:therapeutic use
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; D002118:Calcium