PTX appears to have a protective effect against radiation damage. This protective effect is mediated in part by decreasing both inflammatory reactions and oxidative stress.
Total thyroidectomy (TT) has emerged as a surgical option in the surgical treatment of patients with multinodular goiter. TT carries potential risk to all parathyroid glands and both recurrent laryngeal nerve. The aims of this study are to evaluate the difference between serum calcium levels before and after total and near total thyroidectomy and to compare the rate of postoperative hypocalcemia according to surgical procedures. This prospective study included 143 consecutive patients undergoing surgical therapy for non-toxic multinodular goiter. Patients were randomly assigned to surgical procedures. Patients in group 1 (n=75) performed TT, and patients in group 2 (n=68) performed near total thyroidectomy (NTT). The difference between serum calcium levels and percentage decrease in serum calcium levels before and after thyroidectomy were calculated. TT had a 33-fold (OR: 33.1; 95% CI: 7.5-145.02) increased risk for hypocalcemia. Moreover, TT had a 8-fold (OR: 8.09; 95% CI: 3-21.4) and a 27-fold (OR: 27.9; 95% CI: 3.5-219.6) higher risk than NTT for moderate and severe percentage decreases in serum calcium level, respectively. NTT can offer an advantage over TT in terms of postoperative hypocalcemia in the patients with benign multinodular goiter.
High irPTH level is significantly associated with postoperative hypocalcemia. The irPTH assay is sufficient to identify hypocalcemia in the majority of patients and it is a sensitive tool to identify patients at risk of developing postoperative hypocalcemia.
These results indicate that a flapless thyroidectomy is safe and technically feasible, and therefore could be an alternative to a conventional thyroidectomy.
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