Year 2021,
Volume: 7 Issue: 1, 69 - 73, 30.04.2021
Oğuz Catal
,
Bahri Özer
,
Mustafa Sit
,
Songül Peltek Özer
References
- 1. Hakami Y, Khan A. Hypoparathyroidism. Parathyroid Disorders.Front Horm Res. 2019;51:109-26.
- 2. Fong J, Khan A. Hypocalcemia: updates in diagnosis and management for primary care. Can Fam Physician. 2012;58(2):158-62.
- 3. Chincholikar SP, Ambiger S. Association of hypomagnesemia with hypocalcemia after thyroidectomy. Indian JEndocrinol Metab. 2018;22(5):656.
- 4. Caglia P, Puglisi S, Buffone A, Bianco SL, Okatyeva V, Veroux M, et al. Post-thyroidectomy hypoparathyroidism, what should we keep in mind? Ann Ital Chir. 2017;6:371-81.
- 5. Falch C, Hornig J, Senne M, Braun M, Konigsrainer A, Kirschniak A, et al. Factors predicting hypocalcemia after total thyroidectomy–A retrospective cohort analysis. Int J Surg. 2018;55:46-50.
- 6. Seo GH, Chai YJ, Choi HJ, Lee KE. Incidence of permanent hypocalcaemia after total thyroidectomy with or without central neck dissection for thyroid carcinoma: a nationwide claim study. Clin Endocrinol. 2016;85(3):483-7.
- 7. Shoback D. Hypoparathyroidism. N Engl J Med. 2008;359(4):391-403.
- 8. Bobanga ID, McHenry CR. Treatment of patients with Graves' disease and the appropriate extent of thyroidectomy. Best Prac & Res Clin Endocrinol Metab. 2019;33(4):101319.
- 9. Del Rio P, Rossini M, Montana CM, Viani L, Pedrazzi G, Loderer T, et al. Postoperative hypocalcemia: analysis of factors influencing early hypocalcemia development following thyroid surgery. BMC surg. 2019;18(1):25.
10. Vasileiadis I, Charitoudis G, Vasileiadis D, Kykalos S, Karatzas T. Clinicopathological characteristics of incidental parathyroidectomy after total thyroidectomy: the effect on hypocalcemia. A retrospective cohort study. Int J Surg. 2018;55:167-74.
- 11. Orloff LA, Wiseman SM, Bernet VJ, Fahey III TJ, Shaha AR, Shindo ML, et al. American thyroid association statement on postoperative hypoparathyroidism: diagnosis, prevention, and management in adults. Thyroid. 2018;28(7):830-41.
- 12. Maurer E, Maschuw K, Reuss A, Zieren HU, Zielke A, Goretzki P, et al. Total Versus Near-total Thyroidectomy in Graves Disease: Results of the Randomized Controlled Multicenter TONIG-trial. Ann Surg. 2019;270(5):755-61.
- 13. Zong Y, Li K, Dong K, Yao W, Liu G, Xiao X. The surgical choice for unilateral thyroid carcinoma in pediatrics: Lobectomy or total thyroidectomy? J Pediatr Surg. 2018;53(12):2449-53.
- 14. Wang B, Zhu C-R, Liu H, Wu J. The effectiveness of parathyroid gland autotransplantation in preserving parathyroid function during thyroid surgery for thyroid neoplasms: A meta-analysis. PloS one. 2019;14(8):e0221173.
- 15. Kong D-D, Wang W, Wang M-H. Superior parathyroid blood supply safety in thyroid cancer surgery: a randomized controlled trial. Int J Surg. 2019;64:33-9.
- 16. Kazaure HS, Zambeli-Ljepovic A, Oyekunle T, Roman SA, Sosa JA, Stang MT, et al. Severe Hypocalcemia After Thyroidectomy: An Analysis of 7366 Patients. Ann Surg. 2019.
- 17. Malik MZ, Mirza AA, Farooqi SA, Chaudhary NA, Waqar M, Bhatti HW. Role of Preoperative Administration of Vitamin D and Calcium in Postoperative Transient Hypocalcemia after Total Thyroidectomy. Cureus. 2019;11(4).
- 18. Sasson AR, Pingpank Jr JF, Wetherington RW, Hanlon AL, Ridge JA. Incidental parathyroidectomy during thyroid surgery does not cause transient symptomatic hypocalcemia. Arch Otolaryngol Head Neck Surg. 2001;127(3):304-8.
The Effect of Incidental Parathyroidectomy on Hypocalcemia in Benign and Malignant Thyroid Patients
Year 2021,
Volume: 7 Issue: 1, 69 - 73, 30.04.2021
Oğuz Catal
,
Bahri Özer
,
Mustafa Sit
,
Songül Peltek Özer
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.
References
- 1. Hakami Y, Khan A. Hypoparathyroidism. Parathyroid Disorders.Front Horm Res. 2019;51:109-26.
- 2. Fong J, Khan A. Hypocalcemia: updates in diagnosis and management for primary care. Can Fam Physician. 2012;58(2):158-62.
- 3. Chincholikar SP, Ambiger S. Association of hypomagnesemia with hypocalcemia after thyroidectomy. Indian JEndocrinol Metab. 2018;22(5):656.
- 4. Caglia P, Puglisi S, Buffone A, Bianco SL, Okatyeva V, Veroux M, et al. Post-thyroidectomy hypoparathyroidism, what should we keep in mind? Ann Ital Chir. 2017;6:371-81.
- 5. Falch C, Hornig J, Senne M, Braun M, Konigsrainer A, Kirschniak A, et al. Factors predicting hypocalcemia after total thyroidectomy–A retrospective cohort analysis. Int J Surg. 2018;55:46-50.
- 6. Seo GH, Chai YJ, Choi HJ, Lee KE. Incidence of permanent hypocalcaemia after total thyroidectomy with or without central neck dissection for thyroid carcinoma: a nationwide claim study. Clin Endocrinol. 2016;85(3):483-7.
- 7. Shoback D. Hypoparathyroidism. N Engl J Med. 2008;359(4):391-403.
- 8. Bobanga ID, McHenry CR. Treatment of patients with Graves' disease and the appropriate extent of thyroidectomy. Best Prac & Res Clin Endocrinol Metab. 2019;33(4):101319.
- 9. Del Rio P, Rossini M, Montana CM, Viani L, Pedrazzi G, Loderer T, et al. Postoperative hypocalcemia: analysis of factors influencing early hypocalcemia development following thyroid surgery. BMC surg. 2019;18(1):25.
10. Vasileiadis I, Charitoudis G, Vasileiadis D, Kykalos S, Karatzas T. Clinicopathological characteristics of incidental parathyroidectomy after total thyroidectomy: the effect on hypocalcemia. A retrospective cohort study. Int J Surg. 2018;55:167-74.
- 11. Orloff LA, Wiseman SM, Bernet VJ, Fahey III TJ, Shaha AR, Shindo ML, et al. American thyroid association statement on postoperative hypoparathyroidism: diagnosis, prevention, and management in adults. Thyroid. 2018;28(7):830-41.
- 12. Maurer E, Maschuw K, Reuss A, Zieren HU, Zielke A, Goretzki P, et al. Total Versus Near-total Thyroidectomy in Graves Disease: Results of the Randomized Controlled Multicenter TONIG-trial. Ann Surg. 2019;270(5):755-61.
- 13. Zong Y, Li K, Dong K, Yao W, Liu G, Xiao X. The surgical choice for unilateral thyroid carcinoma in pediatrics: Lobectomy or total thyroidectomy? J Pediatr Surg. 2018;53(12):2449-53.
- 14. Wang B, Zhu C-R, Liu H, Wu J. The effectiveness of parathyroid gland autotransplantation in preserving parathyroid function during thyroid surgery for thyroid neoplasms: A meta-analysis. PloS one. 2019;14(8):e0221173.
- 15. Kong D-D, Wang W, Wang M-H. Superior parathyroid blood supply safety in thyroid cancer surgery: a randomized controlled trial. Int J Surg. 2019;64:33-9.
- 16. Kazaure HS, Zambeli-Ljepovic A, Oyekunle T, Roman SA, Sosa JA, Stang MT, et al. Severe Hypocalcemia After Thyroidectomy: An Analysis of 7366 Patients. Ann Surg. 2019.
- 17. Malik MZ, Mirza AA, Farooqi SA, Chaudhary NA, Waqar M, Bhatti HW. Role of Preoperative Administration of Vitamin D and Calcium in Postoperative Transient Hypocalcemia after Total Thyroidectomy. Cureus. 2019;11(4).
- 18. Sasson AR, Pingpank Jr JF, Wetherington RW, Hanlon AL, Ridge JA. Incidental parathyroidectomy during thyroid surgery does not cause transient symptomatic hypocalcemia. Arch Otolaryngol Head Neck Surg. 2001;127(3):304-8.