Incidence and Prediction of Hypoparathyroidism after Total Thyroidectomy

Abstract

INTRODUCTION : Hypocalcemia caused by hypoparathyroidism is the most common postoperative complication after total thyroidectomy. The aim of this study is to determine the incidence of hypoparathyroidism and the time course of recovery from hypoparathyroidism.MATERIALS and METHODS : 105 patients who underwent total thyroidectomy with central compartment dissection from Jan 2011 to June 2012 in Jeju national university hospital were reviewed retrospectively. Serum PTH and calcium levels tested before and after surgery were analyzed.RESULTS : Transient hypoparathyroidism was found in fifty-one patients (48.6%) at seond postoperative days. But most of them recovered with the course of time (15.2% in 8 weeks, 6.7% in 5 months, 2.9% in 9 months after surgery), and persistent hypoparathyroidism was remained in only one patient at one years after surgery. Preoperative PTH level showed a significant positive correlation with the PTH levels at POD#2 (Pearson r=0.277； p<0.004), but it was not a good predictor for the postoperative hypoparathyroidism in ROC curve analysis (AUC=0.507).CONCLUSIONS : About half of patients undergoing total thyroidectomy developed hypoparathyroidism, but most of them recovered within several months. The preoperative PTH was correlated with postoperative hypoparathyroidism significantly, but it was not appropriate to predict postoperative hypoparathyroidism.