The mechanism of hypocalcaemia following thyroidectomy

Percival, Richard; Hargreaves, A W; Kanis, John А.

doi:10.1530/acta.0.1090220

Cited by 46 publications

(29 citation statements)

References 12 publications

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“…In several studies, the incidence of transient hypocalcemia varied from 6.9% 39 to 46%, 40,41 while a rate of 0.4% to 33% has been reported for permanent hypoparathyroidism. 14,39 In the present study, transient hypoparathyroidism occurred in 27.8% of cases-568 patients-and it was mostly manifested as transient hypocalcemia, which was easily managed with oral supplementation of vitamin D and Ca +3 .…”

Section: Discussionmentioning

confidence: 99%

Complications and risk factors related to the extent of surgery in thyroidectomy. Results from 2,043 procedures

Karamanakos¹,

Markou²,

Panagopoulos³

et al. 2010

125

117

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OBJECTIVE: To evaluate the rate of complications and the risk factors in relation to the extent of surgery in patients undergoing thyroidectomy in a tertiary university center. DESIGN: Data were collected retrospectively from 2,043 consecutive patients who underwent thyroid surgery for various thyroid diseases at the University Hospital of Patras, Greece, between January 1996 and December 2007. recurrent laryngeal nerve palsy (rLNP) and hypoparathyroidism were set as the primary end points, while hematoma and wound infection were set as the secondary endpoints. rESULTS: Total, near-total and subtotal thyroidectomy was performed in 1,149, 777 and 117 patients, respectively. Transient rLNP occurred in 34 (1.6%) and permanent in 19 (0.9%) patients. Multivariate logistic regression analysis showed that extended resection (Or-odds ratio-1.6), Graves' disease (Or 2.7), thyroiditis (Or 2.1), recurrent goiter (Or 2.3) and thyroid malignancy (Or 1.7) were all independent risk factors for transient rLNP, whereas Graves' disease (Or 2.2) and recurrent goiter (Or 1.7) emerged as independent risk factors for permanent rLNP. The rates of transient and permanent hypoparathyroidism were 27.8% and 4.8%, respectively. Multivariate analysis for transient hypoparathyroidism revealed that the extent of surgical resection (Or 2.2), Graves' disease (Or 2.1), recurrent goiter (Or 1.7), female gender (Or 1.5) and specimen weight (Or 1.6) were independent predictors. However, the extent of surgical resection (Or 2.7), Graves' disease (Or 1.8), recurrent goiter (Or 1.5) and malignant disease (Or 1.5) were independent risk factors for permanent hypoparathyroidism. Postoperative wound infection and hematoma occurred in 6 (0.3%) and 27 (1.3%) patients, respectively. No correlation was observed between wound infection or postoperative hemorrhage and the extent of surgery. CONCLUSIONS: Despite the higher morbidity, total thyroidectomy is emerging as an attractive surgical option even for benign thyroid disease due to the risk of subclinical (occult) malignancy, the possibility of goiter relapse as well as of the increased risk of complications following reoperation.

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Section: Discussionmentioning

confidence: 99%

Complications and risk factors related to the extent of surgery in thyroidectomy. Results from 2,043 procedures

Karamanakos¹,

Markou²,

Panagopoulos³

et al. 2010

125

117

View full text Add to dashboard Cite

show abstract

“…Patients must therefore be carefully observed in the postoperative period and have their lab workup done, especially those categorized as high risk patients 1 . Estimates indicate that transient hyperparathyroidism prevalence rates range between 6.9% and 46% and permanent hyperparathyroidism rates vary from 0.4% to 33% [2][3][4][5] . Hypocalcemia may occur secondarily to surgical trauma, devascularization, unintentional removal of parathyroid glands, reoperation, and total thyroidectomy 6 .…”

Section: Introductionmentioning

confidence: 99%

Estudo prospectivo da hipocalcemia clínica e laboratorial após cirurgia da tireoide

Dedivitis¹,

Pfuetzenreiter²,

Nardi³

et al. 2010

Braz. j. otorhinolaryngol. (Impr.)

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Hypocal cemia can be detected clinically and through lab tests after thyroidectomy. Aim: To analyze the incidence and risk factors of clinical and laboratorial hypocalcemia after thyroid surgery. Methods: Prospective study of 91 patients undergoing thyroidectomy. Demographics, intraoperative, and pathological aspects were correlated to our hypocalcemia findings. Results: Age higher than 50 (p = 0.022) and complete thyroidectomy (p < 0.001) were considered risk factors for hypoparathyroidism. Complete thyroidectomy was considered a risk factor for the 48-hour laboratorial hypoparathyroidism (p = 0.004). There was no risk factor associated with the one-month laboratorial hypoparathyroidism. There was significance between the 48-hour and the one-month laboratorial hypoparathyroidism. Conclusions: Thyroidectomy extension is a risk factor for both the clinical and laboratorial hypoparathyroidism, whereas age is a risk factor for clinical hypoparathyroidism. The detection of 48-hour laboratorial hypoparathyroidism is a predisposing factor for the one-month laboratorial hypoparathyroidism. However, most of the cases were temporary.

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“…In several studies (1,6,8), the incidence of transient hypocalcemia varied from 6.9 to 46% , while a rate of 0.4 to 33% has been reported for permanent hypoparathyroidism. In the present study, transient hypoparathyroidism occurred in 16.8% of cases.…”

Section: Discussionmentioning

confidence: 99%

Intra- and postoperative complications in 137 cases of giant thyroid gland tumor

Liu

et al. 2012

Oncology Letters

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Abstract. The intra-and postoperative complications resulting from surgery for giant thyroid gland tumors (diameter greater than 10 cm) present serious challenges to patient recovery. Although there are a number of methods, all have limitations. In this study, we present our experience with several complications of surgical treatment of giant thyroid gland tumors to increase the awareness and aid the prevention of these complications. A total of 137 consecutive patients who underwent surgical treatment in Henan Tumor Hospital were retrospectively analyzed. Statistics pertaining to the patients' clinical factors were gathered. We found that the most common surgical complications were recurrent laryngeal nerve (RLN) injury and symptomatic hypoparathyroidism. Other complications included incision site infections, bleeding, infection and chyle fistula, the incidence of which increased significantly with increasing extent of surgery from group I (near-total thyroidectomy) to group V (total thyroidectomy plus lateral neck dissection). Low complication rates may be achieved with more accurate knowledge of the surgical anatomy, skilled surgical treatment and experience. More extensive surgery results in a greater number of complications.

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The mechanism of hypocalcaemia following thyroidectomy

Cited by 46 publications

References 12 publications

Complications and risk factors related to the extent of surgery in thyroidectomy. Results from 2,043 procedures

Complications and risk factors related to the extent of surgery in thyroidectomy. Results from 2,043 procedures

Estudo prospectivo da hipocalcemia clínica e laboratorial após cirurgia da tireoide

Intra- and postoperative complications in 137 cases of giant thyroid gland tumor

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