1. Severe Hypocalcemia after total parathyroidectomy plus autotransplantation for secondary hyperparathyroidism-risk factors and management
周逢復1 黃純真2 陳靖博3 詹宜嘉1 紀順裕1
高雄長庚紀念醫院外科部一般外科1 解剖病理科2 內科部腎臟科3
Fong-Fu Chou1, Shun-Chen Huang2, Jin-Bor Chen3, Yi-Chia Chan1, Shun-Yu Chi1
Division of General Surgery1, Department of Surgery, Anatomic Pathology2, Division of Nephrology3, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital

2. ☆ Post-parathyroidectomy hypocalcemia is quite common
Background:
☆ Post-parathyroidectomy hypocalcemia is quite common
☆ It tends to be more severe and prolonged in patients with secondary hyperparathyroidism with rates high up to 36-97%
☆ The majority of patients require intravenous I.V. calcium gluconate, oral calcium carbonate/acetate and calcitriol
☆ There are no available, controlled studies on calcium supplement for post-parathyroidectomy hypocalcemia  

3. Materials and Methods:
☆ From Jan 2011 to Oct 2017, 269 patients who were successfully operated on for secondary hyperparathyroidism were included in this study.
☆ They were divided into two groups: Group A patients had severe hypocalcemia (≦6.5mg/dL) or needed i.v. 4 gm or more of calcium gluconate in the post-operative hospitalization; Group B patients had mild hypocalcemia (>6.5mg/dL) and needed less than i.v. 4 gm of calcium gluconate in the postoperative hospitalization.
☆ Successful surgery was defined as serum iPTH levels less than 72 pg/mL within one week after surgery