갑상선유두암에서 갑상선전절제술과 중심경부림프절절제술 후 발생하는 저칼슘혈증 예측 인자 연구Factors Predicting Hypocalcemia after Total Thyroidectomy with Central Lymph Node Dissection in Papillary Thyroid Cancer
- Other Titles
- Factors Predicting Hypocalcemia after Total Thyroidectomy with Central Lymph Node Dissection in Papillary Thyroid Cancer
- Authors
- 이옥주; 김형철; 임철완; 신응진; 조규석; 정준철; 정귀애; 김지선; 정재홍; 최규성; 한선욱; 허성모
- Issue Date
- 2015
- Publisher
- 대한갑상선-내분비외과학회
- Keywords
- 갑상선암; 갑상선전절제술; 저칼슘혈증; 부갑상선호르몬; Thyroid cancer; Total thyroidectomy; Hypocalcemia; Parathyroid hormone
- Citation
- The Journal of Endocrine Surgery, v.15, no.3, pp.60 - 66
- Journal Title
- The Journal of Endocrine Surgery
- Volume
- 15
- Number
- 3
- Start Page
- 60
- End Page
- 66
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/11222
- ISSN
- 2508-8149
- Abstract
- Purpose: Total thyroidectomy with central lymph node dissection (CLND) is a treatment modality of choice for thyroid cancer. Hypocalcemia is the most common complication after total thyroidectomy. The aim of the current study was to determine the association between surgery-related clinical factors and postoperative hypocalcemia.Methods: A prospective analysis was performed for 101 patients who underwent total thyroidectomy with CLND for papillary cancer from June 2013 to June 2014. Correlation between clinicopathologic factors and postoperative hypocalcemia was analyzed.Results: Based on the postoperative day-2 calcium, 56 patients (55%) developed hypo-calcemia and 45 patients (45%) were normal. No significant differences in histopathologic (tumor size, tumor focality, histologic type, number of retrieved lymph nodes, metastatic lymph node, thyroiditis, retrieved parathyroid gland) findings were observed between the hypocalcemia group and normal calcium group. Mean value of the postoperative day-0 parathyroid hormone (PTH) was significantly lower in the hypocalcemia group (hypoca1cemiagroup: 14.3±9.4 pg/mL; normal group: 25.0±16.4 pg/mL; P<0.001). In logistic regression analysis, postoperative PTH was a factor significantly affecting postoperative hypocalcemia (OR 0.93; CI: 0.90-0.97; P<0.001). In ROC analysis, the cut-off value of PTH was 19.965 (sensitivity 79%, specificity 58%), and area under the curve (AUC) was 0.709 (95% CI: 0.607-0.811).Conclusion: Postoperative PTH was a factor predicting hypocalcemia after total thyroidectomy with CLND. Use of postoperative PTH as a screening tool for prediction of postoperative hypocalcemia would be useful in management of patients with hypocal-cemia.
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Collections - College of Medicine > Department of General Surgery > 1. Journal Articles
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