Intraoperative parathyroid hormone measurement facilitates outpatient thyroidectomy in children. Am J Surg 2021 Apr;221(4):683-686
Date
03/03/2021Pubmed ID
33648715DOI
10.1016/j.amjsurg.2021.02.009Scopus ID
2-s2.0-85101711295 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
INTRODUCTION: We hypothesize that intraoperative parathyroid hormone (ioPTH) measurement after a total thyroidectomy predicts children at risk for hypoparathyroidism and allow for outpatient procedure.
METHODS: Between 2015 and 2019, we reviewed all patients under the age of 21 undergoing a thyroidectomy (total or lobectomy). Based on the ioPTH concentration, the patients were treated by the following protocol: a) PTH ≥20 pg/mL: no treatment; b) PTH = 10-19 pg/mL: 1000 mg calcium orally TID; c) PTH = 5-9 pg/mL: calcitriol 250 μg orally BID plus 1000 mg calcium orally TID; or d) PTH <5 pg/mL calcitriol 500 μg orally BID plus 1000 mg calcium orally TID.
RESULTS: Fifty-two patients were included with a median age of 16 (range 6-21 years). Thirty-two patients (62%) had normal PTH (≥10 pg/mL) while 20 (38%) had low PTH levels (<10 pg/mL). Of those patients with low PTH, 60% had normalization of levels within 2 weeks of surgery.
CONCLUSIONS: Thyroid surgery in children can be performed as an outpatient procedure. The ioPTH measurements and a protocol to treat patients with low PTH assists in safe discharge.
Author List
Obiarinze R, Fazendin J, Iyer P, Lindeman B, Chen HAuthor
Pallavi Iyer MD Chief, Associate Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Calcium
Child
Humans
Hypocalcemia
Hypoparathyroidism
Outpatients
Parathyroid Hormone
Thyroidectomy
Young Adult
