Hypoparathyroidism in Total Thyroidectomy due to Benign Thyroid Diseases

Ertaş, Burak; Veyseller, Bayram; Karataş, Abdullah; Özdilek, Alper; Doğan, Remzi; Özturan, Orhan

doi:10.1016/j.clinthera.2018.04.004

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…However, almost all the HRQOL differences disappeared at 6 and 12 months postoperatively. In examining this resolution, studies showed that the incidences of transient hypocalcemia and recurrent laryngeal nerve paralysis were much higher than those of permanent changes, and most of the complications resolved within 6 months postoperatively . The intergroup differences of HRQOL disappeared at 6 and 12 months after surgery, along with the complications.…”

Section: Discussionmentioning

confidence: 98%

Association of Total Thyroidectomy or Thyroid Lobectomy With the Quality of Life in Patients With Differentiated Thyroid Cancer With Low to Intermediate Risk of Recurrence

Chen

Peng

et al. 2022

JAMA Surg

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IMPORTANCEOwing to the good prognosis of differentiated thyroid cancer (DTC), guidelines recommend total thyroidectomy (TT) or thyroid lobectomy (TL) as surgical treatment for DTC with low to intermediate risk of recurrence. However, the association of these surgeries with the health-related quality of life (HRQOL) of patients with DTC with low to intermediate risk of recurrence is unclear.OBJECTIVE To longitudinally compare the HRQOL of patients with DTC undergoing different surgeries. DESIGN, SETTING, AND PARTICIPANTSThis prospective observational longitudinal cohort study enrolled patients diagnosed with DTC with low to intermediate risk of recurrence at the First Affiliated Hospital, Sun Yat-sen University, China, from October 1, 2018, to September 31, 2019. Eligible patients were categorized into TL and TT groups according to the surgery they underwent. They were evaluated preoperatively and followed up at 1, 3, 6, and 12 months postoperatively using 3 HRQOL-related questionnaires (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, version 3.0; Hospital Anxiety and Depression Scale; and Thyroid Cancer-Specific Quality of Life Questionnaire); serum thyrotropin levels, complications, and patient satisfaction were also monitored. Data were analyzed to compare the HRQOL of patients undergoing different surgeries at different time points.EXPOSURES Total thyroidectomy or TL. MAIN OUTCOMES AND MEASURESThe primary end point was HRQOL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, version 3.0; Hospital Anxiety and Depression Scale; and Thyroid Cancer-Specific Quality of Life Questionnaire) at different time points, and the secondary end points were postoperative complications, thyrotropin level, and patient satisfaction. RESULTS Of the 1060 eligible patients, 563 underwent TL (438 women [77.8%]; median [IQR] age, 38 [31-45] years), and 497 underwent TT (390 women [78.5%]; median [IQR] age, 38 [32-48] years). Compared with the TL group, including the 1-to 4-cm tumor subgroup, the TT group experienced more postoperative HRQOL problems at 1 and 3 months postoperatively. However, nearly all the differences disappeared at 6 and 12 months postoperatively. CONCLUSIONS AND RELEVANCEResults of this study suggest that HRQOL of patients with DTC with low to intermediate risk of recurrence is not associated with the extent of surgery, and HRQOL may not be an important consideration when making surgical decisions. If better HRQOL is requested in the short term, TL may be preferred.

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Section: Discussionmentioning

confidence: 98%

Association of Total Thyroidectomy or Thyroid Lobectomy With the Quality of Life in Patients With Differentiated Thyroid Cancer With Low to Intermediate Risk of Recurrence

Chen

Peng

et al. 2022

JAMA Surg

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“…The most practical approaches include the identification the parathyroid glands and the careful protection of their vascular supply [32]. However, owing to the varied location of the parathyroid gland and the distorted anatomy after the previous surgery, these strategies were not always possible [33].…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation versus reoperation for benign thyroid nodules that developed after previous thyroid surgery

Yan

Deng

Song

et al. 2021

International Journal of Hyperthermia

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Purpose: To compare the clinical outcomes of radiofrequency ablation (RFA) versus reoperation for benign thyroid nodules that developed after previous thyroid surgery. Methods: A total of 53 patients with 53 benign nodules developed after previous thyroid surgery were evaluated in this retrospective study. Eighteen patients were treated by RFA (RFA group) and 35 patients underwent reoperation (reoperation group). The efficacy, safety, thyroid function, blood loss, hospitalization, total treatment time, and cost were compared between the two groups. Results: In the RFA group, the mean volume decreased significantly from 12.78 ± 17.57 ml to 0.94 ± 1.01 ml (p ¼ 0.043) with a volume reduction rate of 85.27 ± 14.35% and significant improvement in symptom and cosmetic scores (all p ¼ 0.001). Therapeutic efficacy was achieved with a single session in all thyroid nodules. The total treatment time (6.12 ± 3.17 min vs. 110.26 ± 44.41 min, p < 0.001), blood loss (0 ml vs. 82.58 ± 105.55 ml, p < 0.001) and hospitalization(0 days vs. 9.66 ± 4.28 days, p < 0.001) were significantly lower in the RFA group than those in reoperation group, but the costs of treatment were similar(2262.12 ± 221.54 USD vs. 2638.04 ± 1062.90 USD, p ¼ 0.081). The incidence of complications was significantly higher in the reoperation group than in the RFA group(31.43 vs. 0%, p < 0.001). Furthermorre, 65.17% of patients developed hypothyroidism after reoperation, whereas the thyroid function of the patients in the RFA group was unaffected. Conclusion: For patients with benign thyroid nodules developed after previous thyroid surgery, RFA can be considered as a safe and effective alternative to reoperation with advantages of maintenance of intact thyroid function and low incidence of complications.

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Predictive value of parathyroid hormone levels for permanent hypoparathyroidism at different time points after papillary thyroid cancer surgery

Gao

Zhang

Wang

et al. 2023

Preprint

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Purpose To investigate the relationship between parathyroid hormone (PTH) levels on day 1 after radical thyroid surgery for papillary carcinoma and permanent hypoparathyroidism (PHPP) and the predictive value of the relationship between them. Methods Eighty patients with papillary thyroid cancer who underwent total thyroidectomy and lymph node dissection in the central area admitted to the General Surgery Department of Gansu Provincial People’s Hospital from January 2021 to January 2022 were collected and analyzed. Patients were divided into hypoparathyroidism and normal parathyroid groups according to whether PHPP occurred after surgery, and the correlation between parathyroid hormone (PTH) and serum calcium levels and permanent hypoparathyroidism (PHPP) on postoperative day 1 in both groups was analyzed using univariate and binary logistics regression. The area under the subject operating curve (ROC) was used to assess the predictive validity of PTH for the occurrence of PHPP in the postoperative period. Results PHPP occurred in 10 of the 80 patients with papillary thyroid cancer included, with an incidence of 12.5%; binary logistic regression analysis showed that PTH on a postoperative day 1 (OR = 14.534, 95% CI: 2.377 to 88.858, P = 0.004), was an independent predictive risk factor for the development of PHPP after surgery. The area under the curve (AUC) was 0.874 (95% CI: 0.79–0.958, P = 0.000) with a sensitivity of 71.4%, specificity of 100%, and Jorden index of 0.714, using PTH = 8.75ng/L on postoperative day 1 as the threshold value. Conclusions PTH levels on day 1 after total thyroid papillary carcinoma are strongly associated with permanent hypoparathyroidism and are an independent predictor of the development of PHPP.

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Hypoparathyroidism in Total Thyroidectomy due to Benign Thyroid Diseases

Cited by 3 publications

References 19 publications

Association of Total Thyroidectomy or Thyroid Lobectomy With the Quality of Life in Patients With Differentiated Thyroid Cancer With Low to Intermediate Risk of Recurrence

Association of Total Thyroidectomy or Thyroid Lobectomy With the Quality of Life in Patients With Differentiated Thyroid Cancer With Low to Intermediate Risk of Recurrence

Radiofrequency ablation versus reoperation for benign thyroid nodules that developed after previous thyroid surgery

Predictive value of parathyroid hormone levels for permanent hypoparathyroidism at different time points after papillary thyroid cancer surgery

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