The Effect of Incidental Parathyroidectomy on Hypocalcemia in Benign and Malignant Thyroid Patients

Abstract

Objective: Hypocalcemia is characterized by clinical findings resulting from a decrease in serum calcium (Ca2+) and many etiological factors may cause this condition. The most common cause of postoperative hypocalcemia is hypoparathyroidism and the most frequent complication that occurs after thyroid surgery is hypocalcemia. We aimed to investigate the effect of incidental parathyroidectomy on postoperative early hypocalcemia in patients after thyroid surgery. Methods: Retrospectively analyzed the data of patients who underwent thyroidectomy in General Surgery Department of Abant Izzet Baysal University between January 2009 and December 2018. Age, gender, serum Ca2+ and parathormone (PTH) levels were obtained. The histopathological results of thyroidectomy materials were grouped as benign (Group 1) and malignant (Group 2). Results: The study population was consisted of 3841 patients. 3154 patients were in group 1 and 687 patients were in group 2. The postoperative average serum Ca2+ levels of group 1 and 2 were 8.50 mg/dl (6.80-9.80) and 8,50 mg/dl (6.80-9.80), respectively (p=0.996). Postoperative PTH levels of group 1 and 2 were 44.5 ng/l (0-65) and 44.5 ng/l (0-65), respectively (p=0.979). Overall postoperative hypocalcemia (8.4 mg/dL) was observed in 1742 (45.4%) patients. There was no difference in Ca2+ and PTH levels between group 1 and group 2. Incidental parathyroidectomy (%5.4) was performed in 209 of total study population who underwent thyroidectomy. 155 (4.9%) and 54 (7.9%) of the patients in groups 1 and 2, respectively and the incidental parathyroidectomy rates of the groups were statistically different (p=0.02). Conclusion:We think that incidental parathyroidectomy does not stimulate the development of postoperative hypocalcemia.

Hypoparathyroidism: Early Detection and Diagnosis Approaches

“…Misalnya, ketika seorang pasien dengan riwayat operasi leher sebelumnya datang dengan gejala hipokalsemia dan memiliki kadar PTH yang rendah, hipoparatiroidisme dapat ditegakkan. Namun, kadar PTH yang bersirkulasi pada pasien ini juga dapat berada dalam kisaran normal (Catal et al, 2021;Maeda et al, 2018). Demikian pula untuk mendiagnosis pasien dengan hiperparatiroidisme, untuk mendiagnosis pasien dengan hipoparatiroidisme, nilai PTH harus dipertimbangkan dalam kaitannya dengan nilai kalsium serum yang diambil secara bersamaan (Bilezikia, 2020).…”