Comparative study of preoperative versus postoperative parathormone hormone level to predict hypocalcemia earlier after near total thyroidectomy

Background: Hypocalcemia due to hypoparathyroidism is the most common complication of thyroid surgery. Postoperative hypocalcemia caused by deficiency in parathormone hormone is resulted by inhibition of bone resorption, a reduction in the renal biosynthesis of 1‐25‐ dihydroxy cholecalciferol and decreased alimentary calcium absorption. Objective: To assess the role of parathormone level postoperative in prediction of hypocalcemia earlier after near total thyroidectomy in comparison to preoperative values. Methodology: This is an interventional prospective study that was carried out on (30) patients aged from 21 to 55 years old. As regard sex, there were 4 males (13.3%) and 26 females (86.7%) who underwent near total thyroidectomy with follow up of 24 hours preoperative and 24 hours postoperative of serum parathyroid hormone (PTH) level, serum total and ionized calcium levels and serum vitamin D levels. Results: Monitoring of parathyroid hormone (PTH) level in the first 24 hours post operative revealed that 4 patients (13.3%) of the studied cases developed post-operative hypocalcemia with post operative hypoparathyroidism. Mean postoperative values of total calcium, ionized calcium and PTH were lower than preoperative values. However, there is no difference between values of PO4 and vitamin D in postoperative and preoperative. Conclusion: Determination of PTH levels in the first 24 hours postoperative is an important method for early detection of post operative hypocalcemia whether temporary or permanent even if no clinical manifestations appeared. Subsequently, aids the early treatment of the condition and early discharge of the patients.