Postoperative Hypoparathyroidism: Prognosis, Prevention, and Treatment (Review)

Melikyan, A.A.; Меньков, А В

doi:10.17691/stm2020.12.2.13

Cited by 11 publications

(8 citation statements)

References 77 publications

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“…Большинство ученых считает, что целью лечения больных ДТЗ является достижение эутиреоидного состояния с минимальными осложнениями для пациента [25,26].…”

Section: лечениеunclassified

“…В случае серьезной аллергической реакции назначать альтернативный препарат не рекомендуется. Редкие, но серьезные побочные эффекты включают гепатит, антифосфолипидный синдром и агранулоцитоз (количество нейтрофилов <500 / мл), который встречается в 0,1-1,0% случаев [8,11,15,26].…”

Section: лечениеunclassified

“…Послеоперационный гипопаратиреоз (ПОГПТ) является часто встречающимся осложнением хирургического вмешательства на ЩЖ, обусловленным травмой или удалением околощитовидных желез [25,42]. По данным различных авторов, после тиреоидэктомии транзиторный гипопаратиреоз встречается существенно чаще (в 0,9-68% случаев), чем стойкий гипопаратиреоз (частота 1-10%) [11,26]. Частота возникновения ПОГПТ зависит от объема оперативного вмешательства на ЩЖ, а также от опыта хирурга.…”

Section: осложнения хирургических вмешательствunclassified

“…Диагностика ПОГПТ основывается на результатах исследования уровня кальция (общего с поправкой на альбумин и ионизированного), фосфора в сыворотке крови и уровня ПТГ [25,53]. Исследования различных авторов описывают, что одним из критериев развития ПОГПТ является снижение уровня ПТГ в первые сутки после операции менее 15 пг/мл, другие авторы указывают на концентрацию ПТГ менее 10 пг/мл [7,26,53]. Таким образом, уровень ПТГ рекомендуется проверять сразу в послеоперационном периоде.…”

Section: осложнения хирургических вмешательствunclassified

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Topical issues of toxic goiter diagnosis and treatment

Makarov,

Galkin,

Shpigel

et al. 2023

Aspirantskiy Vestnik Povolzhiya

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Section: лечениеunclassified

Section: осложнения хирургических вмешательствunclassified

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Topical issues of toxic goiter diagnosis and treatment

Makarov,

Galkin,

Shpigel

et al. 2023

Aspirantskiy Vestnik Povolzhiya

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“…Meanwhile, a failure to return to normal levels of parathyroid function that lasts for more than 6 months is defined as permanent hypoparathyroidism, although there is a study that apply 12 months as the time cut-off point for the diagnosis of permanent hypoparathyroidism (10). The incidence of temporary hypoparathyroidism is 1.6-53.6% (11), while that of permanent hypoparathyroidism is as high as approximately 3% (12), and its clinical manifestations are mainly numbness and convulsions, decreasing the quality of life in patients and, in some cases, leading to death (13,14).…”

Section: Introductionmentioning

confidence: 99%

Establishing a predictive model of hypoparathyroidism after total thyroidectomy and central lymph node dissection for postoperative calcium supplementation selectively

Huang¹,

Zhong²,

He³

et al. 2022

Ann Transl Med

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Background:The core goal of this article is to find some meaningful risk factors that can affect the postoperative hypoparathyroidism of thyroid cancer, create an effective prediction model on this basis, and use it to selectively implement routine prophylactic calcium supplementation for patients after thyroid carcinoma surgery. Methods:The clinicopathological characteristics of patients with papillary thyroid carcinoma (PTC) who underwent conventional bilateral total thyroidectomy (TT) + bilateral central lymph node dissection from January 2020 to August 2021 in the Affiliated Hospital of Nantong University were retrospectively analyzed.Firstly, this study analyzed the relationship between postoperative hypocalcemia and hypoparathyroidism.Then, we included many potential risk factors such as gender, age, body mass index (BMI), lateral lymph node dissection (LLND) and so on and also performed univariate and multivariate analysis of the independent risk factors for postoperative hypoparathyroidism in patients, and established a predictive scoring model.Results: Among the 401 patients with PTC, 50.1% developed postoperative hypoparathyroidism.There was significant difference in serum calcium concentration between normal parathyroid group and hypoparathyroidism group after thyroid carcinoma surgery. BMI <24 kg/m 2 , lateral lymph node dissection, multifocality, and extrathyroidal extension (ETE) were all identified as independent risk factors for postoperative hypoparathyroidism. Based on these independent risk factors, a nine-point risk scoring model was created to firstly assess the postoperative parathyroid function status of patients and then to determine whether routine prophylactic calcium supplementation is needed. Importantly, the area under the curve (AUC) of the risk scoring model is equal to 0.979.Conclusions: At present, prophylactic calcium supplementation after thyroid carcinoma surgery is a controversial postoperative treatment. It should be selectively implemented for high-risk patients with hypoparathyroidism after surgery. Routine prophylactic calcium supplementation is recommended for PTC patients with a score greater than or equal to 5, although there are no clinical symptoms of postoperative hypocalcemia caused by hypoparathyroidism. However, prophylactic calcium supplementation is not recommended for patients with PTC with a score of less than 5; if the patient develops hypocalcemia at the later stage, therapeutic calcium supplementation can then be implemented.

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Iatrogenic Hypoparathyroidism Development After Thyroidectomy: A Retrospective Cohort Study

Alomari,

Abu Shanab,

Bajunaid

et al. 2024

Endocrino Diabet & Metabol

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BackgroundIatrogenic hypoparathyroidism is a common cause of postthyroidectomy hypocalcaemia. It has varying incidence rates after neck surgery in Saudi Arabia, ranging from 0.07% to 65.30%. Hypoparathyroidism can manifest with a spectrum of symptoms, ranging from mild to severe and life‐threatening. This study aimed to assess the rate and predictors of iatrogenic hypoparathyroidism after thyroid surgery and its natural course.MethodsThis retrospective cohort study used a data collection form to extract patient information from the electronic healthcare system (Best‐Care) for patients treated from 2017 to 2022. Patients' demographics, surgical specifics and biochemical profiles were recorded for subsequent analysis.ResultsAmong the 343 patients who underwent thyroidectomy, 130 (37.9%) developed hypoparathyroidism, primarily within the first day after surgery. Calcium or vitamin D supplementation before surgery did not significantly influence hypoparathyroidism development. Notably, extensive combined lymph node dissection was significantly associated with postoperative hypoparathyroidism development (p = 0.0004). More patients who underwent central and lateral lymph node dissection (n = 19, 79.17%) developed hypoparathyroidism than patients who underwent central (n = 18, 40.91%) or lateral (n = 8, 38.10%) dissection alone. Permanent hypoparathyroidism was observed in 40 patients (11.66%).ConclusionThis study revealed a high incidence of iatrogenic hypoparathyroidism and high rates of permanent hypoparathyroidism. Further research is warranted to better comprehend the risk factors and optimise management strategies for iatrogenic hypoparathyroidism. Overall, our findings emphasise the need for vigilant monitoring and effective management of patients undergoing thyroidectomy and the significance of postoperative replacement therapies.

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Postoperative Hypoparathyroidism: Prognosis, Prevention, and Treatment (Review)

Cited by 11 publications

References 77 publications

Topical issues of toxic goiter diagnosis and treatment

Topical issues of toxic goiter diagnosis and treatment

Establishing a predictive model of hypoparathyroidism after total thyroidectomy and central lymph node dissection for postoperative calcium supplementation selectively

Iatrogenic Hypoparathyroidism Development After Thyroidectomy: A Retrospective Cohort Study

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