Postoperative Hypoparathyroidism in Patients After Total Thyroidectomy - Experience of a Tertiary Center in Romania

Martin, Sorina; Parfeni, Ovidiu; Mustata, Theodor; Andrei, Marian; Sîrbu, Anca; Barbu, Carmen; Enciu, Octavian; Andrei, Florin; Fica, Simona

doi:10.21614/chirurgia.114.5.602

Cited by 6 publications

(7 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The literature reports a wide range of incidence of transient and permanent PoH and duration of hypocalcemia 11 – 13 . In our study, total thyroidectomy patients did not receive extra effort to intraoperatively identify the parathyroid glands but special care was taken not to disrupt supply to the glands.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risks and prediction of postoperative hypoparathyroidism due to thyroid surgery

Yazıcıoğlu

Yilmaz

Kocaöz

et al. 2021

Sci Rep

View full text Add to dashboard Cite

We aimed to investigate the prevalence of postoperative hypoparathyroidism (PoH), the relevant factors, and predictors of transient or permanent hypoparathyroidism. The files of 352 patients who underwent bilateral total thyroidectomy alone or with central lymph node dissection and/or lateral neck dissection between June 1, 2019, and November 30, 2019, were retrospectively evaluated. Also, calcium and parathyroid hormone levels measured preoperatively and 4–6 h after surgery, follow-up examination results, and time to resolution of transient PoH were recorded. 16.48% (n = 58) of the surgical patients developed transient PoH and 3.98% (n = 14) developed permanent PoH. Length of hospital stay increased in patients who developed PoH (p < 0.001). Transient PoH developed less in patients who underwent parathyroid autotransplantation, while permanent PoH was not detected (p = 0.001). PoH development was not significantly correlated with nodule size as measured by preoperative thyroid ultrasonography (p = 0.944). Patients who had a serum PTH level ≤ 5.95 pmol/L 4–6 h after surgery had a greater risk of developing permanent PoH (OR 134.84, 95% CI 17.25–1053.82). PoH is more common in female gender and is not significantly correlated with nodule size. Parathyroid autotransplantation can prevent the development of PoH.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In cases of incidental parathyroidectomy, the glands were implanted in the sternocleidomastoid muscle. The mean time to resolution of transient PoH is reported to be 60 days on average 3 , 13 . In our study, PTH levels of patients who developed PoH returned to normal within 28 days on average.…”

Section: Discussionmentioning

confidence: 99%

Risks and prediction of postoperative hypoparathyroidism due to thyroid surgery

Yazıcıoğlu

Yilmaz

Kocaöz

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Some authors emphasize the importance of postoperative measurement of PTH and the fact that a decrease in their levels can predict the development of hypocalcemia due to thyroidectomy (19). When symptoms occur after thyroidectomy, both calcium and magnesium should be corrected and monitored (20).…”

Section: Discussionmentioning

confidence: 99%

Persistent Hypocalcemia after Thyroidectomy Stabilized with Magnesium

2020

View full text Add to dashboard Cite

We present the case of a 53-year-old woman who underwent total thyroidectomy as a multinodular goiter treatment, which after surgery presented hypocalcemia that did not reverse with combined therapy of calciotropic hormones and calcium supplementation. The symptomatology remission was reached only after the prescription of magnesium lactate tablets. It is known that hypocalcemia is the main complication of this surgery, however, little is known about hypomagnesemia and its role as a cause and consequence of the imbalance in calcium homeostasis in this kind of patients. The clinical and biochemical evolution of the patient is evaluated, as well as the pathophysiology of hypocalcemia due to magnesium deficiency that involves a large number of processes such as renal, intestinal and bone function.

show abstract

“…La hipocalcemia posoperatoria (POP) es una complicación bien reconocida de la tiroidectomía total, que se caracteriza por la presencia de hipocalcemia, con niveles de hormona paratiroidea (PTH) bajos o inadecuadamente normales (1, 2). Su prevalencia es variable y oscila entre el 10 y el 83 % (1, [3][4][5][6][7][8][9]. Esto se explica por la técnica quirúrgica y las diferentes definiciones usadas.…”

Section: Introductionunclassified

Hipocalcemia severa o sintomática secundaria a hipoparatiroidismo posoperatorio en cirugía de tiroides: experiencia en un hospital universitario de Medellín, Colombia

Gonzalez

Ríos

Velásquez

et al. 2020

Rev.ACE

View full text Add to dashboard Cite

Objetivo: caracterizar la población de pacientes que presentan hipocalcemia severa o sintomática después de una tiroidectomía total y que requieren calcio parenteral. Diseño: estudio observacional retrospectivo realizado en un centro especializado de Medellín, Colombia. Marco de referencia: la hipocalcemia posoperatoria (POP) es una complicación bien reconocida de la tiroidectomía, que se caracteriza por la presencia de hipocalcemia, con niveles de hormona paratiroidea (Parathyroid hormone, PTH) bajos o inadecuadamente normales. La hipocalcemia sintomática o severa (calcio corregido <7,5 mg/dL) es una verdadera emergencia médica, que requiere un rápido diagnóstico y tratamiento con calcio parenteral. Pacientes: pacientes en POP de tiroidectomía que presentan hipocalcemia severa o sintomática. Intervenciones: reposición con calcio parenteral. Resultados: la hipocalcemia severa o sintomática se presentó en el 8 % de los pacientes llevados a una tiroidectomía total, con predominio en el sexo femenino. La patología tiroidea maligna se constituyó en la indicación más frecuente de la cirugía. En estos pacientes, la media de la PTH fue de 11,3 pg/ mL, mientras que los valores de calcio más bajos se presentaron a las 48 horas POP. Solo se visualizaron las paratiroides en cirugía en una tercera parte de los casos y un paciente tuvo una reintervención en las primeras 24 horas; hasta el 18 % tuvieron hipomagnesemia concomitante. Conclusión: la hipocalcemia por hipoparatiroidismo POP es una complicación frecuente después de la cirugía de tiroides, y en un grupo de pacientes será severa o sintomática, razón por la cual requiere uso de calcio parenteral. En consecuencia, esta complicación tendrá que identificarse y tratarse como una emergencia médica para disminuir la morbilidad y la potencial mortalidad asociadas.

show abstract

Postoperative Hypoparathyroidism in Patients After Total Thyroidectomy - Experience of a Tertiary Center in Romania

Cited by 6 publications

References 22 publications

Risks and prediction of postoperative hypoparathyroidism due to thyroid surgery

Risks and prediction of postoperative hypoparathyroidism due to thyroid surgery

Persistent Hypocalcemia after Thyroidectomy Stabilized with Magnesium

Hipocalcemia severa o sintomática secundaria a hipoparatiroidismo posoperatorio en cirugía de tiroides: experiencia en un hospital universitario de Medellín, Colombia

Contact Info

Product

Resources

About