What is the immediate postoperative course for patients who have undergone thyroidectomy?

Updated: May 08, 2018
  • Author: Neerav Goyal, MD, MPH; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

In the authors' practice, patients who have undergone thyroidectomy remain overnight for a 23-hour stay. Some surgeons perform thyroid surgery on an outpatient basis. [39] Patients who undergo a total thyroidectomy have their calcium levels monitored for iatrogenic hypoparathyroidism. Recent studies have compared the use of postoperative parathyroid hormone as an adjunct or replacement to measuring serum calcium levels in predicting hypoparathyroidism. Al-Dhahri et al describes the use of postoperative PTH 6 hours after surgery with a cutoff of 1.7 pmol/L as being more accurate at predicting which patients are at risk for hypocalcemia. [40] Graff et al, on the other hand, note that a PTH value less than 14 pg/mL was 100% sensitive and 83% specific, while combining this value with a postoperative serum calcium raised specificity to 88%. [41]

Long-term monitoring

Patients undergoing a total thyroidectomy are iatrogenically hypothyroid following the operation. Medical management of hypothyroidism and continued monitoring are imperative. Those patients with thyroid cancer should also be monitored for disease recurrence.


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