title: Importance of the intraoperative appearance of preserved parathyroid glands after total thyroidectomy.
abstract: OBJECTIVE
  Hypocalcemia after total thyroidectomy is a concern for every endocrine surgeon. We conducted this study to establish the value of the macroscopic appearance of preserved parathyroid glands after thyroidectomy in predicting post-thyroidectomy hypocalcemia.
  
  
  METHODS
  In 2009, 237 patients underwent total thyroidectomy at our hospital. The macroscopic appearance of the preserved parathyroid glands was recorded and the serum calcium and intact parathyroid hormone levels were measured postoperatively.
  
  
  RESULTS
  Thirteen patients (5.5 %) had transient hypocalcemia and 1 patient (0.4 %) had permanent hypocalcemia. All of the hypocalcemia patients with more than one normal preserved parathyroid had asymptomatic transient hypocalcemia that did not require medication. The sensitivity, specificity, positive predictive value, and negative predictive value for hypocalcemia with at least 1 normal preserved parathyroid were 78.6, 79.4, 19.3, and 98.3 %, respectively.
  
  
  CONCLUSIONS
  The macroscopic appearance of preserved parathyroid glands and the number of well-preserved parathyroid glands after thyroidectomy proved effective in predicting post-thyroidectomy hypocalcemia.
authors: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwan-gil, Songpa-Gu, Seoul, 138-736, Korea.
authors: Tae-Yon
authors: TY
authors: Sung
authors: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwan-gil, Songpa-Gu, Seoul, 138-736, Korea.
authors: Yu-mi
authors: YM
authors: Lee
authors: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwan-gil, Songpa-Gu, Seoul, 138-736, Korea.
authors: Jong Ho
authors: JH
authors: Yoon
authors: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwan-gil, Songpa-Gu, Seoul, 138-736, Korea.
authors: Ki-Wook
authors: KW
authors: Chung
authors: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwan-gil, Songpa-Gu, Seoul, 138-736, Korea. sjhong2@amc.seoul.kr.
authors: Suck Joon
authors: SJ
authors: Hong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood; D002277:Carcinoma / Q000601:surgery; D005260:Female; D005544:Forecasting; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000209:etiology; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments; D010280:Parathyroid Glands / Q000473:pathology*; D010281:Parathyroid Hormone / Q000097:blood; D011183:Postoperative Complications; D011184:Postoperative Period; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium
keywords: Hypocalcemia; Parathyroid glands; Thyroidectomy