ASSESSMENT OF INTRA OPERATIVE PARATHYROID HORMONE LEVEL: AS AN INDICATOR FOR POST-OPERTIVE CALCIUM THERAPY IN A PATIENT UNDERGOING NEAR TOTALAND TOTAL THYROIDECTOMY

Abstract

Thyroid and parathyroid are anatomically close to each other. Blood supply to parathyroid may get cut off inadvertently or all parathyroid tissue may get removed removed during near total or total thyroidectomy.As a result of near total and total thyroidectomy it may lead to hypocalcemia crisis post-operatively causing tingling, numbness, tetany, neuro-muscular dysfunction.Hypocalcemia is the most common etiological factor for prolonged hospitalization in patients undergoing total thyroidectomy.Recent studies concludes that, hypocalcemia can be prevented by assessing S. PTH levels pre-operatively and intra-operatively one hour after removing the gland.This study includes 30 patients, who underwent near total and total thyroidectomy from August 2018-July2020 with thyroid swelling where indicated for surgery.Patients who underwent total thyroidectomy for malignancy (10 out of 30) developed hypocalcemia, this attributed to the extensive surgical dissection performed in malignant disorders in order to obtain tumour clearance.For the Stratication of thyroidectomy patients who may develop hypocalcemia into low and high risk category, a single 1-hour post-thyroidectomy PTH level is very useful.