Fatores preditores para hipocalcemia pós-tireoidectomia

Sousa, Alexandre de Andrade; Salles, José Maria Porcaro; Soares, João Marcos Arantes; Moraes, Gustavo Meyer de; Carvalho, Jomar Rezende; Savassi-Rocha, Paulo Roberto

doi:10.1590/s0100-69912012000600006

Cited by 28 publications

(13 citation statements)

References 21 publications

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“…Sousa et al . [ 13 ] showed that incidence of postoperative hypocalcemia is more in papillary carcinoma compared to follicular carcinoma as papillary carcinoma associated with neck dissection. The suspect nodule and the follicular adenoma are usually treated with partial thyroidectomy; therefore, the incidence of hypocalcemia was lower.…”

Section: Discussionmentioning

confidence: 99%

Association of hypomagnesemia with hypocalcemia after thyroidectomy

Chincholikar

Ambiger

2018

Indian J Endocr Metab

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Background:Hypocalcemia is one of the most common acceptable complications in postoperative period after thyroidectomy. Hypomagnesemia has been recognized after parathyroid surgery, and it has not been studied extensively after thyroidectomy. The aim of this study was to estimate magnesium and calcium ion levels in patients undergoing thyroidectomy and to evaluate the association of hypomagnesemia with hypocalcemia after thyroidectomy. A prospective study was conducted in Government Medical College, Calicut, from December 2012 to November 2013.Materials and Methods:all patients had undergone total/near-total/subtotal thyroidectomy. Pre- and postoperative at 24 h and serum calcium and magnesium were measured by automate electrolyte analyzer. Clinical findings of hypocalcemia were recorded. Statistical analysis was done using SPSS software, version 17.0. Unpaired student t-test was used. Pearson Chi-square test or Fisher's exact test was used to compare the percentage for categorical variables.Results:In our study, 58% of the patients developed hypocalcemia, biochemical and/or symptomatic (S. Ca <8.5). About 34% of patients developed hypomagnesemia, biochemical and/or symptomatic (S. Mg <1.7). About 30% of patients developed both hypocalcemia and hypomagnesemia. About 24% of patients developed symptoms of both hypocalcemia and hypomagnesemia.Discussion:Thyroidectomy patients were at a risk of transient and permanent hypoparathyroidism because of chances of parathyroid resection during operation. Transient hypocalcemia and hypomagnesemia occur frequently after total thyroidectomy. It is important to monitor both calcium and magnesium levels after total thyroidectomy and to correct deficiencies to facilitate prompt resolution of symptoms.Conclusion:There is an association of hypomagnesemia with hypocalcemia after thyroidectomy.

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Section: Discussionmentioning

confidence: 99%

Association of hypomagnesemia with hypocalcemia after thyroidectomy

Chincholikar

Ambiger

2018

Indian J Endocr Metab

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“…Earlier studies also provide various other factors such as age, basic pathology, and duration of surgery as reasons for increased incidence of hypocalcemia. 23 When all glands are compromised by injury of the vascular pedicle, resection or unintended surgical manipulation and sudden significant fall in levels of PTH occur, leading to more intense and faster hypocalcemia, hence causing the symptoms. With partial preservation of the function of the parathyroid glands, the PTH decrease is less significant, remaining so until there is retrieval or repair of the remaining glands of the ischemic parathyroid cells.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy: a retrospective Chinese population study

Wang¹,

Bhandari²,

Yang³

et al. 2017

CMAR

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BackgroundHypocalcemia is one of the most common postoperative complications following thyroid surgery in clinical practice. The occurrence of hypocalcemia is mainly attributed to hypoparathyroidism when parathyroid glands are devascularized, injured, or dissected during the surgery. The aim of this study was to analyze the risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy.Patients and methodsA total of 278 patients who underwent thyroid surgery were analyzed retrospectively. Univariate analysis and multivariable logistic regression were performed to discover the risk factors for hypocalcemia and hypoparathyroidism.ResultsPostoperative hypocalcemia occurred in 76 (27.3%) patients and hypoparathyroidism occurred in 42 (15.1%) patients. Seven factors were significantly related to the presence of postoperative hypocalcemia, namely, age (P=0.049), gender (P=0.015), lateral lymph node dissection (P=0.017), operation type (P<0.001), preoperative parathyroid hormone (PTH) level (P=0.035), operation time (P=0.001), and applying carbon nanoparticles (CNs; P=0.007). Our result revealed that gender (P=0.014), lateral lymph node dissection (P=0.038), operation type (P<0.001), operative time (P<0.001), and applying CNs (P=0.001) had a significant correlation with postoperative hypoparathyroidism.ConclusionThese findings were crucial for guiding surgeons to prevent the occurrence of hypocalcemia and hypoparathyroidism.

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“…In the study by Sousa Ade et al [34], the incidence of post-thyroidectomy hypocalcaemia and definitive hypoparathyroidism were highest in patients >50 years of age. Advanced age could be an own risk factor for developing hypoparathyroidism [35].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of permanent hypoparathyroidism following thyroid surgery varies from 0.9 to 6.6%, depending on surgical expertise and the extent of resection [1,2,3,4,5], and may reach 2.9% following bilateral subtotal resection [6,7,8]. Post-surgical hypoparathyroidism is usually due to inadvertent or unavoidable parathyroid gland removal, and/or damage to the parathyroid blood supply.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Truncal Ligation of the Inferior Thyroid Artery during Bilateral Subtotal Thyroidectomy Causes a Decrease in Parathormone without Clinically Manifest Hypoparathyroidism: A Randomized Clinical Trial

2015

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Background: Bilateral truncal ligation (BTL) of the inferior thyroid artery (ITA) is frequently used during subtotal thyroidectomy to reduce the risk of post-operative bleeding as well as to reduce the blood loss intra-operatively. However, its effect on parathyroid function has not been evaluated in relation to age, residual and resected thyroid volume. Methods: A total of 83 patients were randomized to receive non-BTL or BTL. After bilateral resection, the residual thyroid tissue on each side was measured by intra-operative ultrasonography. Laboratory and clinical examinations were performed the day before operation, intra-operatively and on post-operative days 2 and 5. The primary outcome measure was the difference in intact parathormone (PTHi) on post-operative day 5. Secondary outcomes were laboratory-diagnosed hypocalcaemia or hypoparathyroidism and clinically manifest hypoparathyroidism, respectively. Results: PTHi on post-operative day 5 was significantly lower in the BTL group (29.4 vs. 34.7 ng/l in the non-BTL group, p = 0.033), especially in 61- to 80-year-old patients (0 vs. -7.91 ng/l, p = 0.029). The biggest decline in PTHi was found in the BTL group (-14.067 ng/l PTH, p = 0.018) with a residual thyroid volume of 0.5-1.9 ml. There were two cases of asymptomatic hypoparathyroidism in each group (5.1 vs. 4.8%, respectively, p = 1.000). The only case of clinically manifest hypoparathyroidism was in a BTL group patient aged 64 years (2.4%, p = 1.000). Conclusion: BTL of the ITA during subtotal thyroidectomy causes a larger decrease in PTH but does not lead to a significantly higher rate of clinically manifest hypoparathyroidism. BTL of the ITA, age >61 years, and a very small thyroid remnant (<2 ml) may be risk factors for post-operative hypoparathyroidism.

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Fatores preditores para hipocalcemia pós-tireoidectomia

Abstract: predictors of postoperative hypocalcemia included age (> 50 years), total thyroidectomy, reoperation, neck dissection and operative time. The predictors of post-thyroidectomy definitive hypoparathyroidism included type of operation, histological diagnosis and hyperthyroidism.

Cited by 28 publications

References 21 publications

Association of hypomagnesemia with hypocalcemia after thyroidectomy

Association of hypomagnesemia with hypocalcemia after thyroidectomy

Risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy: a retrospective Chinese population study

Bilateral Truncal Ligation of the Inferior Thyroid Artery during Bilateral Subtotal Thyroidectomy Causes a Decrease in Parathormone without Clinically Manifest Hypoparathyroidism: A Randomized Clinical Trial

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