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Is There a Regular Pattern in the Recovery of Parathyroid Function After Thyroid Cancer Surgery?
Cancer Management and Research ( IF 3.3 ) Pub Date : 2021-09-03 , DOI: 10.2147/cmar.s326705 Xi-Yu Yao 1 , Yan Zhou 2 , Shun-Jin Chen 1 , Yu Wu 1 , Cong Bian 1 , Hongbin Chen 1 , Hui Liu 1
Cancer Management and Research ( IF 3.3 ) Pub Date : 2021-09-03 , DOI: 10.2147/cmar.s326705 Xi-Yu Yao 1 , Yan Zhou 2 , Shun-Jin Chen 1 , Yu Wu 1 , Cong Bian 1 , Hongbin Chen 1 , Hui Liu 1
Affiliation
Purpose: To investigate whether there is a pattern of recovery of parathyroid function after thyroid cancer surgery.
Patients and Methods: The study included 183 patients with papillary thyroid cancer (PTC) who underwent “total thyroidectomy (TT)” plus “unilateral central lymph node dissection (UCLND)” or “bilateral central lymph node dissection (BCLND)”. The intact parathyroid hormone (iPTH) and serum calcium (sCa) were analyzed several times within 1 month after surgery to explore the recovery pattern of parathyroid gland function. Then, these 183 cases were divided into group A (97 cases) with UCLND and group B (86 cases) with BCLND to analyze whether the impairment and recovery of parathyroid function were different between the two subgroups.
Results: Postoperative hypoparathyroidism was seen in 115 out of 183 cases. iPTH values decreased significantly on postoperative day (POD) 1 compared with preoperative values, dropped to the lowest point on POD 3, showed an increasing trend on POD 5 and 14, and increased to 85.0% of preoperative values at POD30, whereas changes in sCa differ from changes in iPTH, which showed the lowest sCa value on POD1, and rebounded on the POD3 with the intervention of calcium supplementation, and continued to rise on the POD5 and POD14, and the sCa value reached 96.6% of the preoperative level at POD30. Subgroup analysis showed that temporary hypoparathyroidism was more pronounced in group B than in group A. SCa and iPTH levels in both subgroups showed the same trend of first decrease and then increase.
Conclusion: The recovery of hypocalcemia and hypo-iPTHemia in the first month after thyroid cancer surgery shows a trend of decreasing and then increasing, and knowing the recovery of parathyroid function at different time points is of great value to surgeons and patients alike.
Keywords: hypoparathyroidism, hypocalcaemia, parathyroid hormone, thyroid carcinoma, thyroidectomy, lymph node dissection
中文翻译：
甲状腺癌手术后甲状旁腺功能的恢复是否有规律？
目的：探讨甲状腺癌手术后甲状旁腺功能恢复的模式。
患者和方法：该研究纳入了 183 名接受“全甲状腺切除术 (TT)”加“单侧中央淋巴结清扫术 (UCLND)”或“双侧中央淋巴结清扫术 (BCLND)”的甲状腺乳头状癌 (PTC) 患者。术后1个月内多次分析完整甲状旁腺激素（iPTH）和血钙（sCa），探讨甲状旁腺功能恢复规律。然后，将这183例患者分为UCLND A组（97例）和BCLND B组（86例），分析两个亚组甲状旁腺功能受损和恢复是否存在差异。
结果：183 例中有 115 例出现术后甲状旁腺功能低下。iPTH 值在术后第 1 天（POD）较术前值显着下降，在第 3 天降至最低点，在第 5 天和第 14 天呈上升趋势，在术后第 30 天增加到术前值的 85.0%，而 sCa 的变化与iPTH变化不同，在POD1时sCa值最低，在补钙干预后在POD3时回升，在POD5和POD14时持续上升，在POD30时sCa值达到术前水平的96.6% . 亚组分析显示，B组暂时性甲状旁腺功能减退症较A组更为明显。两个亚组的SCa和iPTH水平均呈现先下降后上升的趋势。
结论：甲状腺癌术后第一个月低钙血症和低iPTH血症的恢复呈先降后升的趋势，了解甲状旁腺功能在不同时间点的恢复情况对外科医生和患者都有重要价值。
关键词：甲状旁腺功能减退，低钙血症，甲状旁腺激素，甲状腺癌，甲状腺切除术，淋巴结清扫术
更新日期：2021-09-02
Patients and Methods: The study included 183 patients with papillary thyroid cancer (PTC) who underwent “total thyroidectomy (TT)” plus “unilateral central lymph node dissection (UCLND)” or “bilateral central lymph node dissection (BCLND)”. The intact parathyroid hormone (iPTH) and serum calcium (sCa) were analyzed several times within 1 month after surgery to explore the recovery pattern of parathyroid gland function. Then, these 183 cases were divided into group A (97 cases) with UCLND and group B (86 cases) with BCLND to analyze whether the impairment and recovery of parathyroid function were different between the two subgroups.
Results: Postoperative hypoparathyroidism was seen in 115 out of 183 cases. iPTH values decreased significantly on postoperative day (POD) 1 compared with preoperative values, dropped to the lowest point on POD 3, showed an increasing trend on POD 5 and 14, and increased to 85.0% of preoperative values at POD30, whereas changes in sCa differ from changes in iPTH, which showed the lowest sCa value on POD1, and rebounded on the POD3 with the intervention of calcium supplementation, and continued to rise on the POD5 and POD14, and the sCa value reached 96.6% of the preoperative level at POD30. Subgroup analysis showed that temporary hypoparathyroidism was more pronounced in group B than in group A. SCa and iPTH levels in both subgroups showed the same trend of first decrease and then increase.
Conclusion: The recovery of hypocalcemia and hypo-iPTHemia in the first month after thyroid cancer surgery shows a trend of decreasing and then increasing, and knowing the recovery of parathyroid function at different time points is of great value to surgeons and patients alike.
Keywords: hypoparathyroidism, hypocalcaemia, parathyroid hormone, thyroid carcinoma, thyroidectomy, lymph node dissection
中文翻译：
甲状腺癌手术后甲状旁腺功能的恢复是否有规律？
目的：探讨甲状腺癌手术后甲状旁腺功能恢复的模式。
患者和方法：该研究纳入了 183 名接受“全甲状腺切除术 (TT)”加“单侧中央淋巴结清扫术 (UCLND)”或“双侧中央淋巴结清扫术 (BCLND)”的甲状腺乳头状癌 (PTC) 患者。术后1个月内多次分析完整甲状旁腺激素（iPTH）和血钙（sCa），探讨甲状旁腺功能恢复规律。然后，将这183例患者分为UCLND A组（97例）和BCLND B组（86例），分析两个亚组甲状旁腺功能受损和恢复是否存在差异。
结果：183 例中有 115 例出现术后甲状旁腺功能低下。iPTH 值在术后第 1 天（POD）较术前值显着下降，在第 3 天降至最低点，在第 5 天和第 14 天呈上升趋势，在术后第 30 天增加到术前值的 85.0%，而 sCa 的变化与iPTH变化不同，在POD1时sCa值最低，在补钙干预后在POD3时回升，在POD5和POD14时持续上升，在POD30时sCa值达到术前水平的96.6% . 亚组分析显示，B组暂时性甲状旁腺功能减退症较A组更为明显。两个亚组的SCa和iPTH水平均呈现先下降后上升的趋势。
结论：甲状腺癌术后第一个月低钙血症和低iPTH血症的恢复呈先降后升的趋势，了解甲状旁腺功能在不同时间点的恢复情况对外科医生和患者都有重要价值。
关键词：甲状旁腺功能减退，低钙血症，甲状旁腺激素，甲状腺癌，甲状腺切除术，淋巴结清扫术
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