Vol.96 No.12 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 96 No.12 December 2003
Intact-PTH Level after Surgery for Thyroid Cancer
Hideaki Tsuzuki, Shigeharu Fujieda, Masafumi Sakashita, Myungmi Oh,
Norihiko Narita, Takeshi Tanaka, Akihiro Kojima and Hitoshi Saito
(University of Fukui)
We determined the level of serum intact parathyroid hormone (intact-PTH) in 122 thyroid cancer patients after 6 postoperative months. Hemithyroidectomy was performed in 92 patients, subtotal thyroidectomy in 20 patients, and total thyroidectomy in 10 patients. The normal level of intact-PTH in patients who underwent hemithyroidectomy or subtotal thyroidectomy was kept without parathyroid autotransplantation. The level of intact PTH in 89 patients who underwent extirpation of regional lymph nodes was significantly higher than that in 22 with ipsilateral neck dissection or 11 with bilateral neck dissection. There were no clinical factors, such as gender, age, clinical stage, tumor size or pathological classification, showing correlation with the level of postoperative intact-PTH. In the entire series, postoperative permanent hypocalcemia occurred in 9 (7％) patients. Of these 9 patients, 8 had undergone total thyroidectomy and only 1 subtotal thyroidectomy. The strategy for preservation of parathyroid function during total thyroidectomy was determined as follows: 1) preservation of bilateral superior parathyroid gland, 2) preservation of 1 superior parathyroid gland and autotransplantation of at least the other 1 parathyroid gland, or 3) autotransplantation of 2 parathyroid glands.
Key words : intact-PTH, thyroid cancer, total thyroidectomy, parathyroid function, thyroid surgery