Postoperative hypoparathyroidism after total thyroidectomy for thyroid cancer

Teshima, Masanori; Otsuki, Naoki; Morita, Naruhiko; Furukawa, Tatsuya; Shinomiya, Hitomi; Shinomiya, Hirotaka; Nibu, Ken‐ichi

doi:10.1016/j.anl.2018.04.008

Cited by 32 publications

(33 citation statements)

References 14 publications

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“…Large tumors ( ≥ 4 cm) or gross extrathyroidal extension were significant factors for permanent hypoparathyroidism postoperatively. Of 65 patients who underwent total thyroidectomies with bilateral CND, postoperative transient and permanent hypoparathyroidism were found in 44 (68%) and 12 (18%), respectively [27]. Other study showed the risk factors of hypoparathyroidism following total thyroidectomy with CND.…”

Section: Discussionmentioning

confidence: 94%

The effectiveness of prophylactic ipsilateral central neck dissection in selected patients who underwent total thyroidectomy for clinically node-negative unilateral papillary thyroid carcinoma

Kang

Kim

Choi

et al. 2020

Yeungnam Univ J Med

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Background: Prophylactic central neck dissection (CND) in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) remains controversial. The purpose of this study was to evaluate the benefits of prophylactic ipsilateral CND compared with bilateral CND in total thyroidectomy for cN0 unilateral PTC. Methods: We retrospectively enrolled 174 patients who underwent total thyroidectomies with prophylactic CND for cN0 unilateral PTC between January 2009 and May 2010. The prophylactic CND patients were divided into group 1, the ipsilateral CND group (n=74), and group 2, the bilateral CND group (n=100). The incidence of central lymph node metastasis (CLNM) and postoperative complications, such as hypoparathyroidism, recurrent laryngeal nerve injury, and recurrence were assessed. Results: CLNM was found in 22 (29.8%) in group 1 and 69 (69%) in group 2. The incidence of postoperative severe hypocalcemia less than 7.0 was also significantly different (six patients [8.1%] in group 1 and 23 [23%] in group 2; p=0.009). Permanent hypoparathyroidism was significantly more frequent in group 2 (4.1% vs. 19%; p=0.005). However, the incidence of transient hypoparathyroidism, recurrence, and recurrent laryngeal nerve injury was not significantly different. Conclusion: Prophylactic ipsilateral CND has advantage not only to reduce incidence of some complications but also to have similar recurrence rate compared with bilateral CND. We suggest that prophylactic ipsilateral CND may be safe and effective for selected patients undergoing total thyroidectomy for cN0 unilateral PTC.

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Section: Discussionmentioning

confidence: 94%

The effectiveness of prophylactic ipsilateral central neck dissection in selected patients who underwent total thyroidectomy for clinically node-negative unilateral papillary thyroid carcinoma

Kang

Kim

Choi

et al. 2020

Yeungnam Univ J Med

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“…[ 13 , 14 ] However, due to the destruction of blood supply, it always took at least 4 weeks for the autoplastic PGs to recover function. [ 15 – 17 ] During this time, the PGs in site were the primary functional parenchyma. Because of the potential injury from mechanical or thermal trauma, hematoma formation, or/and partial devascularization, the PGs in site might not be able to function fully.…”

Section: Introductionmentioning

confidence: 99%

“…[ 18 , 19 ] Some research confirmed that even if all the PGs were preserved in site, permanent hypoparathyroidism might occur. [ 17 , 20 ]…”

Section: Introductionmentioning

confidence: 99%

“…In consideration of the predictable function of the autoplastic PGs, the uncertain function of the PGs preserved in site, and the variable location of the inferior PGs, some researchers advocated routine inferior PGs autotransplantation to decrease the incidence of postoperative permanent hypoparathyroidism. [ 17 , 20 – 22 ] While the function of the PGs preserved in site needed to be evaluated. Therefore, we conducted this study to compare the performance in the function of the superior parathyroid glands preserved in site with that of the inferior parathyroid glands preserved in site.…”

Section: Introductionmentioning

confidence: 99%

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The inferior parathyroid glands preserved in site recover faster than the superior parathyroid glands preserved in site after thyroid surgery for carcinoma

et al. 2020

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Due to the great difficulty in being preserved in site for the variable positions, the inferior parathyroid glands were advised to being routinely autotransplanted to prevent permanent hypoparathyroidism. The aim of this study was to compare the performance in the function of the superior parathyroid glands preserved in site with that of the inferior parathyroid glands preserved in site. We conducted a retrospective study including patients who underwent thyroid surgery for papillary thyroid carcinoma at our department between January 2014 and June 2018. According to the number and original position of the autoplastic parathyroid gland(s), patients were divided into group 1 (1 superior parathyroid gland), group 2 (1 inferior parathyroid glands), group 3 (1 superior parathyroid gland and 1 inferior parathyroid gland) and group 4 (2 inferior parathyroid glands). The postoperative complications and serum parathyroid hormone and calcium were analyzed. A total of 368 patients were included in the study, among them 27, 243, 40, and 58 patients were divided into group 1, group 2, group 3, and group 4, respectively. Compared with those in group 2, the serum parathyroid hormones were higher at 1 week (2.98 ± 1.52 vs 2.42 ± 0.89, P = .049) and 2 weeks (3.49 ± 1.42 vs 2.8 ± 0.81, P = .019) postoperatively in group 1. There was also significantly different in the serum parathyroid hormone at 2 weeks postoperatively between group 3 and group 4 (2.95 ± 0.98 vs 2.58 ± 0.82, P = .047). The inferior parathyroid glands preserved in site recover faster than the superior parathyroid glands preserved in site.

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“…The primary treatment for thyroid cancer is removal of the thyroid tissue containing the lesions, a procedure called thyroidectomy. [5][6][7] There is also economic burden due to the need to take calcium and vitamin D supplements. [1,2] However, it is difficult to clearly distinguish the parathyroid glands from neighboring tissues because they are similar in color to the naked eye, the surgeon may lack the experience and some patients have a lot of fat tissue around the thyroid.…”

Section: Introductionmentioning

confidence: 99%

Phase‐sensitive fluorescence detector for parathyroid glands during thyroidectomy: A preliminary report

Kim

Lee

et al. 2019

Journal of Biophotonics

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Despite advances in medical technology, the parathyroid glands are still damaged during thyroid surgery. Our previous studies exploring methods for locating the parathyroid glands using autofluorescence have limitations, such as turning off the surgical light or requiring additional matching between the autofluorescence image and realsurgical field-of-view. We developed a probe-type parathyroid autofluorescence detector using a phase-sensitive process and optical filtering to overcome these limitations. A preliminary clinical trial was performed on eight parathyroid glands in four patients. The normalized mean signal of the normal parathyroid glands was 332% stronger than that of the thyroid, and 384%, 459% and 286% stronger than the signal of the muscle, trachea and fat, respectively. Additionally, the device also detected fluorescence from indocyanine green. K E Y W O R D Sautofluorescence, clinical, optical filter, parathyroid gland, phase-sensitive Abbreviations: FOV, field-of-view; ICG, indocyanine green; P/T ratio, parathyroid/thyroid intensity ratio; SNR, signal-to-noise ratio.

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Postoperative hypoparathyroidism after total thyroidectomy for thyroid cancer

Cited by 32 publications

References 14 publications

The effectiveness of prophylactic ipsilateral central neck dissection in selected patients who underwent total thyroidectomy for clinically node-negative unilateral papillary thyroid carcinoma

The effectiveness of prophylactic ipsilateral central neck dissection in selected patients who underwent total thyroidectomy for clinically node-negative unilateral papillary thyroid carcinoma

The inferior parathyroid glands preserved in site recover faster than the superior parathyroid glands preserved in site after thyroid surgery for carcinoma

Phase‐sensitive fluorescence detector for parathyroid glands during thyroidectomy: A preliminary report

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