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KMID : 0378019820250070053
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New Medical Journal
1982 Volume.25 No. 7 p.53 ~ p.58
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The Effect of Portacaval Shunt on Serum Calcium in Total Parathyroidectomized Rat
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Abstract
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Current enthusiasm for radical surgery for all malignant neck diseases will inevitably lead to large increase in debilitating and difficult to control the iatrogenic hypoparathyroidism.
The recent interest in parathyroid gland transplantation has increased in postoperative iatrogenic hypoparathyroidism that could not be managed well with exogenous calcium and vitamine D therapy, but its results were variable (Jacob & Dunphy, 1963; Groth et al_ . 1973; Wells et al., 1973; Wells et al., 1974).
Recently, the possible role of various portal blood factors from the splanchnic circulation on serum calcium regulation, such as secretin, insulin, pancreas extracts, has been proposed as calcium elevating factors (Isenberg et al., 1973; Kaplan et al., 1976; Lee et al., 1980).
And liver plays an important role on serum calcium regulation (Chausmer et al., 1972).
There were reports that hypocalcemia could be prevented and corrected by the portacaval shunt after total parathyroidectomy (Pfeffermann et al., 1977; Lee et al., 1980). The exact role of portacaval shunt on serum calcium regulation in total parathyroidectomized animal is unknown. But there is a possibility of portal blood factors which are not pass through the liver and enter into the systemic circulation after portacaval shunt.
For the purpose of evaluating the effect of portacaval ;shunt on serum calcium level in total parathyrodiectomized rat, the experimental rats were divided into 2 groups, of which group 1 was consisted of Sham neck operation and portacaval shunt, and group 2 was consisted of total parathyroidectomy and portacaval shunt.
The serum calcium levels were checked preoperatively and at every week for 4 weeks after neck operation and portacaval shunt.
The experimental results were as follows;
1. In group 1, the mean serum calcium levels were 9.6±0.6mg/100ml preoperatively,
9.5±0.5mg/100ml at 4 weeks after Sham neck ;operation and 9.5±0.3mg/100ml at 4 weeks after portacaval shunt.
There was no significant change of serum calcium level after portacaval shunt in this control group (p>0.05).
2. In group 2, the mean serum calcium levels were 9.8±0.3mg/100ml preoperatively, 6.2+_0.4mg/100m1 at 4 weeks after total parathyroidectomy. There was significant decrease of serum calcium level after total parathyroidectomy (p<0. 01), and significantly increased to preoperative serum calcilum level at 4 weeks after portacaval shunt (p>0.05).
3. Based on above mentioned results, authors concluded that the portacaval shunt might be regarded as a useful procedure in management of the permanent iatrogenic hypoparathyroidism.
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KEYWORD
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