Risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy: a retrospective Chinese population study

Abstract

BackgroundHypocalcemia is one of the most common postoperative complications following thyroid surgery in clinical practice. The occurrence of hypocalcemia is mainly attributed to hypoparathyroidism when parathyroid glands are devascularized, injured, or dissected during the surgery. The aim of this study was to analyze the risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy.Patients and methodsA total of 278 patients who underwent thyroid surgery were analyzed retrospectively. Univariate analysis and multivariable logistic regression were performed to discover the risk factors for hypocalcemia and hypoparathyroidism.ResultsPostoperative hypocalcemia occurred in 76 (27.3%) patients and hypoparathyroidism occurred in 42 (15.1%) patients. Seven factors were significantly related to the presence of postoperative hypocalcemia, namely, age (P=0.049), gender (P=0.015), lateral lymph node dissection (P=0.017), operation type (P<0.001), preoperative parathyroid hormone (PTH) level (P=0.035), operation time (P=0.001), and applying carbon nanoparticles (CNs; P=0.007). Our result revealed that gender (P=0.014), lateral lymph node dissection (P=0.038), operation type (P<0.001), operative time (P<0.001), and applying CNs (P=0.001) had a significant correlation with postoperative hypoparathyroidism.ConclusionThese findings were crucial for guiding surgeons to prevent the occurrence of hypocalcemia and hypoparathyroidism.

Post-thyroidectomy Hypocalcemia - Risk Factors and Management

“…Post-operatory hypocalcemia has been pointed as the most frequent complication after thyroidectomy in daily practice. This complication, even it seems rather harmless at first, in fact it represents an important element which contributes to hospital delay and, especially for severe forms, and it impacts the quality of life up to the point of developing life threatening forms (24)(25)(26)(27). The cause of hypocalcemia is related to parathyroid gland damage which may be either permanently (very rare) or transitory.…”

“…Low levels of calcium may be registered post-operatory at biochemical level (by testing the total and ionic serum calcium) and also by signs and symptoms commonly known as tetany. The loop of hypocalcemia mechanism that includes low parathormone levels is not always presented (24)(25)(26)(27). The rate of calcium drop after thyroidectomy is also important, not only the values themselves (24).…”

“…The loop of hypocalcemia mechanism that includes low parathormone levels is not always presented (24)(25)(26)(27). The rate of calcium drop after thyroidectomy is also important, not only the values themselves (24). A retrospective study published in 2019 showed that a decrease of 1 mg/dL calcium over 12 hours after surgery is independently correlated with the risk of symptomatic hypocalcemia (24).…”

Nanoparticles can improve the positive rate of metastatic lymph node in thyroid cancer surgery

“…Thyroid cancer is the most common endocrine malignant tumor, and the most common pathological type is papillary thyroid cancer (PTC), accounting for more than 90% of the total thyroid cancer [1][2] .Surgical treatment is the main treatment of this disease 3 ,because of its high rate of lymph node metastasis 4] therefore, the routine cervical lymph node dissection in China increases the injury rate of parathyroid gland and the risk of postoperative hypocalcaemia with the expansion of surgical scope 5 .Studies have shown that carbon nanoparticles can darken lymph nodes and negatively develop parathyroid glands 6 ,it is widely used in thyroid surgery, but whether carbon nanoparticles have a protective effect on parathyroid glands is controversial 10,17 .The purpose of this study was to investigate the value of carbon nanoparticles in thyroid cancer surgery and cervical central lymph node dissection.…”

Hypocalcemia after Total Thyroidectomy – A Prospective Study

“…However, in a few patients, hypoparathyroidism persists after 1 year and may be considered permanent. 9 The occurrence of permanent hypocalcemia is mainly attributed to postoperative hypoparathyroidism when parathyroid glands are devascularized, injured, or dissected during the surgery. 10 The hypocalcemia after surgery is related to multiple factors, including surgical technique, the definition of hypocalcemia, criteria of report series, and use of prophylactic calcium supplementation in the perioperative period.…”