Postoperative Change of Ionized Calcium Level after Total Thyroidectomy and Risk Factors of Postoperative Permanent Hypoparathyroidism / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: The aims of this study were to evaluate postoperative change of ionized calcium level in relation to clinical symptoms of hypoparathyroidism after total thyroidectomy and to find risk factors of postoperative permanent hypoparathyroidism. SUBJECTS AND METHOD: A retrospective study of 118 patients who had underwent total thyroidectomy between January 2000 and July 2003 was performed at the Department of Otolaryngology. Postoperative serum ionized calcium concentration was obtained daily. RESULTS: The incidence of postoperative permanent hypoparathyroidism was 11% (13/118). In the permanent hypocalcemic group, compared with normocalcemic and transient hypocalcemic group, following characteristics were related increased incidence of hypocalemia from postoperative second day, advanced T stage, anaplastic cancer. CONCLUSION: Careful attention was needed for the case with advanced stage to prevent postoperative permanent hypoparathyroidism. It was found that when the second postoperative day's ionized calcium level is below the normal range, daily blood sampling has to be done to detect continuous hypocalcemia.