The importance of extra care for parathyroid gland secure during total thyroidectomy

Abstract

Aim: One of the most common complications after thyroid surgery is hypocalcemia. Hypocalcemia can be seen transiently or permanently. In this study, we aimed to reveal the factors affecting the development of hypocalcemia in patients who underwent total thyroidectomy. Material and Method: The files of the patients who underwent thyroidectomy between September 2009 and December 2014 were reviewed retrospectively. Patient files were reviewed for age, gender, thyroid function tests, postoperative calcium values, pathology reports and peroperative parathyroid auto-implantation. Patients were grouped according to the presence of transient and permanent hypocalcemia. The effects of the obtained data on the effects of transient and permanent hypocalcemia were investigated. Results: Eight hundred and twenty-four patients were included in our study. The mean age of the patients was 46.56 ± 12.52. Of the patients, 115 (14%) were male and 709 (86%) were female. While the incidence of permanent hypocalcemia was 1.3%, the incidence of transient hypocalcemia was 27.3%. Factors affecting the development of transient hypocalcemia were female gender (p <0.001), hyperthyroidism (p <0.001), parathyroid auto-implantation (p = 0.001), and incidental parathyroid excision (p <0.001). The only factor affecting the development of permanent hypocalcemia was incidental parathyroid excision (p <0.001). Discussion: Incidental parathyroid excision has an effect on the development of both transient and permanent hypocalcemia, whereas sex, hyperthyroidism, and parathyroid auto-implantation have an effect on transient hypocalcemia.