Hypocalcemia posthyroidectomy: prevention, diagnosis and management

Mg, Mejia; González-Devia, Deyanira; Fierro, Fernando; Tapiero, M; Rojas, Laura; Cadena-Pineros, E

doi:10.15761/jts.1000212

Cited by 3 publications

(2 citation statements)

References 57 publications

(102 reference statements)

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“…It is almost exclusively seen after total thyroidectomy specially when central neck node dissection (level VI cervical lymph nodes) is combined with thyroid surgery. 2 The reported incidence of post thyroidectomy hypocalcemia varies widely from 1 to 50%. 3 In the present study, none of the patients who underwent hemithyroidectomy (n ¼ 44) experienced significant immediate postoperative hypocalcemia, while there was an average drop of 9.3% in CSC and 40% drop in the iPTH level at 1 hour after total thyroidectomy (n ¼ 36).…”

Section: Discussionmentioning

confidence: 99%

Measurement of Intact Serum Parathormone and Corrected Serum Calcium after Thyroid Surgery

Kumari,

Khanna,

Agrawal

et al. 2023

ANAMS

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Postoperative hypocalcemia is an important complication of thyroid surgery. The present study was undertaken to measure the serum levels of intact parathormone (iPTH) and corrected serum calcium (CSC) in the immediate postoperative period and then sequentially till 1 month after thyroid surgery. A total of 36 patients undergoing total thyroidectomy and 44 undergoing hemithyroidectomy had measurement of the level of iPTH and CSC at 1 hour, 1 day, 1 week, and 1 month after surgery. A mean drop of 9.3% in CSC, 40% in iPTH, and 10% in ionic calcium levels was noted 1 hour after total thyroidectomy. All the patients recovered to near preoperative levels at the 1-month follow-up. Among hemithyroidectomy patients, significant postsurgery drop in levels was not observed. The importance of the study is early recognition of a hypoparathyroid state at 1 hour after surgery and institution of calcium replacement, thereby sparing the patient from unpleasant symptoms of hypocalcemia. Furthermore, patients with a drop in the iPTH levels below the defined hypoparathyroidism levels should have careful evaluation of their thyroidectomy specimen for identification and possible autotransplantation of the parathyroid gland intraoperatively or in the immediate postoperative time frame.

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Section: Discussionmentioning

confidence: 99%

Measurement of Intact Serum Parathormone and Corrected Serum Calcium after Thyroid Surgery

Kumari,

Khanna,

Agrawal

et al. 2023

ANAMS

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“…Es razonable por tanto detectar la deficiencia de vitamina D en pacientes sometidos a cirugía de tiroides como parte del estudio preoperatorio y tratarlos adecuadamente. Esto no es solo para reducir la incidencia, sino también la gravedad de la hipocalcemia, además de otros beneficios a largo plazo del tratamiento de la deficiencia de vitamina D. 5,17,18,21 Magnesio: Importante en la función paratiroidea, su caída estimula la secreción, mientras que la hipermagnesemia inhibe la liberación de PTH. 22 Rui Han Liu y colaboradores analizaron de forma retrospectiva la base de datos MarketScan Commercial Claim and Encounters en 126,766 pacientes ˂65 años sometidos a tiroidectomía total, encontrando que aquellos pacientes con trastornos del magnesio tienen mayor riesgo de hipocalcemia a los 30 días posterior a la tiroidectomía total, 7.4% comparado con 0.8% en aquellos con magnesio normal.…”

Section: A Factores Bioquímicosunclassified

Factores de riesgo, predictores y tratamiento de hipocalcemia en pacientes sometidos a tiroidectomía

Cruz-Joya,

Ramos-Guifarro,

Esquivel-David

et al. 2023

Rev Méd Hondur

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La tiroidectomía total es la intervención más frecuentemente realizada en cirugía endocrina. En manos de cirujanos experimentados el riesgo de hipocalcemia posttiroidectomía disminuye; sin embargo, sigue siendo la principal complicación, alcanzando incidencia hasta 60%. Diversos factores son capaces de predecir el riesgo de hipocalcemia: bioquímicos, quirúrgicos, fisiopatológicos. Se realizó búsqueda en internet de artículos originales, revisiones sistemáticas y artículos de revisión en español e inglés, utilizando plataformas y motores de búsqueda (PubMed, Scielo, Biblioteca Virtual en Salud de Honduras, Google académico), período 2014-2023, utilizando los términos tiroidectomía, hipocalcemia, hipoparatiroidismo, para recopilar datos de diagnóstico, tratamiento y prevención de la hipocalcemia post-tiroidectomía. Se concluyó que la hipocalcemia es la complicación más común posterior a una tiroidectomía. Los predictores de hipocalcemia fueron el calcio sérico, hormona paratiroidea (PTH), vitamina D y magnesio preoperatorio. Los pacientes que desarrollen hipocalcemia deben manejarse según el calcio sérico evaluado la mañana siguiente a la cirugía.

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Surgical Procedures. Thyroidectomy: Indications, Flexible Laryngoscopy, Operative Techniques, Recurrent Laryngeal Nerve Monitoring, and Management of Complications

Bobanga

McHenry

2021

Endocrine Surgery Comprehensive Board Exam Guide

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Hypocalcemia posthyroidectomy: prevention, diagnosis and management

Cited by 3 publications

References 57 publications

Measurement of Intact Serum Parathormone and Corrected Serum Calcium after Thyroid Surgery

Measurement of Intact Serum Parathormone and Corrected Serum Calcium after Thyroid Surgery

Factores de riesgo, predictores y tratamiento de hipocalcemia en pacientes sometidos a tiroidectomía

Surgical Procedures. Thyroidectomy: Indications, Flexible Laryngoscopy, Operative Techniques, Recurrent Laryngeal Nerve Monitoring, and Management of Complications

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