Hypocalcemia – the most common complication after total thyroidectomy

Cmilansky, P; L, Mrozova

doi:10.4149/bll_2014_037

Cited by 14 publications

(4 citation statements)

References 28 publications

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“…Current methods are based on measurement of calcium and PTH levels at different time points, with early (a few minutes to 12 h after thyroid resection) PTH measurements reliably predicting the absence of hypoparathyroidism. Other authors have suggested using quick PTH measurements, which could also help the surgeon decide whether or not to autotransplant a parathyroid gland.…”

Section: Introductionmentioning

confidence: 99%

Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery

Fortuny

Sadowski

Belfontali

et al. 2018

British Journal of Surgery

159

150

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BackgroundHypoparathyroidism, the most common complication after thyroid surgery, leads to hypocalcaemia and significant medical problems. An RCT was undertaken to determine whether intraoperative parathyroid gland angiography with indocyanine green (ICG) could predict postoperative hypoparathyroidism, and obviate the need for systematic blood tests and oral calcium supplementation.MethodsBetween September 2014 and February 2016, patients who had at least one well perfused parathyroid gland on ICG angiography were randomized to receive standard follow‐up (measurement of calcium and parathyroid hormone (PTH) on postoperative day (POD) 1 and systematic supplementation with calcium and vitamin D; control group) or no supplementation and no blood test on POD 1 (intervention group). In all patients, calcium and PTH levels were measured 10–15 days after thyroidectomy. The primary endpoint was hypocalcaemia on POD 10–15.ResultsA total of 196 patients underwent ICG angiography during thyroid surgery, of whom 146 had at least one well perfused parathyroid gland on ICG angiography and were randomized. None of these patients presented with hypoparathyroidism, including those who did not receive calcium supplementation. The intervention group was statistically non‐inferior to the control group (exact 95 per cent c.i. of the difference in proportion of patients with hypocalcaemia –0·053 to 0·053; P = 0·012). Eleven of the 50 excluded patients, in whom no well perfused parathyroid gland could be identified by angiography, presented with hypoparathyroidism on POD 1, and six on POD 10–15, which was significantly different from the findings in randomized patients (P = 0·007).ConclusionICG angiography reliably predicts the vascularization of the parathyroid glands and obviates the need for postoperative measurement of calcium and PTH, and supplementation with calcium in patients with at least one well perfused parathyroid gland. Registration number: NCT02249780 (http://www.clinicaltrials.gov).

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Section: Introductionmentioning

confidence: 99%

Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery

Fortuny

Sadowski

Belfontali

et al. 2018

British Journal of Surgery

159

150

View full text Add to dashboard Cite

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“…The current techniques for evaluating parathyroid function are based on calcium (25,26) and PTH (6,27-31) measurements at various time points during or after thyroidectomy. Some studies have suggested that early (a few minutes to 12 hours after thyroid resection) PTH measurements reliably predict the absence of hypoparathyroidism, with a positive predictive value up to 97% (6,27,28). However, this finding has been challenged by other authors (32,33).…”

Section: Fluorescent Techniques With Icg In Neck Surgerymentioning

confidence: 41%

A reappraisal of vascular anatomy of the parathyroid gland based on fluorescence techniques

Sadowski¹,

Fortuny²,

Triponez³

2017

Gland Surg.

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“…These results were comparable to the studies conducted in past. [23,24] Postoperative other complications among all cases were seroma, transient hoarseness of voice and neck hematoma. [25,26] Shortly after surgery, hypocalcemia is a common occurrence.…”

Section: Hypocalcemiamentioning

confidence: 95%

Frequency of Hypocalcemia after Thyroid Surgery

Butt¹,

Fayyaz²,

Quratulain³

et al. 2022

PJMHS

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Objective: The purpose of this study is to determine the prevalence of hypocalcemia among patients after thyroid surgery. Study Design: Descriptive study/ Cross-sectional Place and Duration: The study was conducted at the surgical department of Mayo Hospital, Lahore for the duration of eighteen months from July 2020 to December 2021. Methods: Fifty-five male and female subjects participated in this research. Patients ranged in age from 17 to 62 years. After obtaining written permission from the patient, demographic information such as age, sex, BMI, and tumors type was collected. Contralateral lobe cancer was also shown to be a problem. Before surgery and on the first post-operative day, the blood calcium levels of the patients were measured. Patients who received a full thyroidectomy were evaluated for signs of hypocalcemia. Analysis was performed using SPSS 22.0. Results: Among 55 patients, majority of the cases were females 30 (54.5%) were females and the rest were males 25 (45.5%). The patients mean age was 37.16±14.52 years and had mean BMI 24.45±6.62 kg/m2. Papillary cancer was the most common tumor found in 42 (76.4%) cases, followed by follicular cancer in 9 (16.4%) case and 4 (7.3%) cases had hurthle cell carcinoma. We found frequency of hypocalcemia in 14 (25.5%) cases. Among 14 patients of hypocalcemia 10 (71.4%) were females and 4 (38.6%) were males. Retrosternal of goiter found in 5 (35.7%) cases and no retrosternal extension found in 9 (64.3%) case. Post-operative other complications among all cases were seroma, transient hoarseness of voice and neck hematoma. Conclusion: In this study we found higher frequency of hypocalcemia in 25.5% cases after thyroid surgery. Majority of the cases were females and had no retrosternal extension. Except hypocalcemia other complications among all cases were seroma, transient hoarseness of voice and neck hematoma. Keywords: Thyroid Surgery, Tumors, Complications, Hypocalcemia

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Hypocalcemia – the most common complication after total thyroidectomy

Cited by 14 publications

References 28 publications

Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery

Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery

A reappraisal of vascular anatomy of the parathyroid gland based on fluorescence techniques

Frequency of Hypocalcemia after Thyroid Surgery

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