Permanent hypocalcemia in patients operated for thyroid carcinoma

Abstract

Aim and objective The incidence and risk factors for permanent hypocalcemia in thyroid carcinoma were investigated. Materials and methodsThe records of 417 patients were reviewed retrospectively at tertiary oncology referral center. Total or subtotal thyroidectomy patients constituted group I (n = 225), reoperative thyroid surgery patients constituted group II (n = 106), and therapeutic neck dissection cases constituted group III (n = 86). Age, gender, thyroid functions, pathologically verifi ed tumor type, differentiation, localization and size, multicentricity, thyroid capsule invasion, extrathyroidal soft tissue invasion, coexistence of lymphocytic thyroiditis, metastatic lymph nodes dissected, incidental parathyroidectomy, and the type of surgery were investigated.Re sults Permanent hypocalcemia was seen in 32 (7.7%) patients. The incidence of permanent hypocalcemia for each group was 1.7%, 10.3% and 19.7%, respectively. Related risk factors were hyperthyroidism for group I [adjusted relative risk (RR) = 21.1, 95% confi dence interval (CI) = 2.6-165, p = 0.01] incidental parathyroidectomy for group II (RR = 7.8, 95% CI = 1.9-31.0, p = 0.004), and extrathyroidal soft tissue invasion (RR = 3.1, 95% CI = 1.1-9.5, p = 0.03) for group III.Conclusion Permanent hypocalcemia rate was increased with reoperative thyroid surgery and neck dissection added to total thyroidectomy. Hyperthyroidism, incidental parathyroidectomy and extrathyroidal extension were related risk factors.

Clinical Utility of Preoperative Vitamin D3 Injection for Preventing Transient Hypocalcemia after Total Thyroidectomy

“…We investigated risk factors associated with TH after TT in 2294 patients with thyroid cancer. The incidence of TH in the present study was 27.8%, which was not significantly different from previous studies [ 27 – 29 ]. The mean preoperative 25-OHD level of study population was 18.9 ng/mL, which was insufficient state (>30 ng/mL, sufficiency).…”

Risk factors for postoperative hypocalcaemia after thyroidectomy: A systematic review and meta-analysis

“…3,9,10,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] The quality of all included studies was assessed using the NOS, of which 10 studies were rated as high quality (four with 8 stars and six with 7 stars) and 13 studies were rated as moderate quality (11 with 6 stars and two with 5 stars) (Table 1). 3,9,10,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] According to the heterogeneity for the meta-analyses on preoperative vitamin D levels (I 2 ¼ 74%, P ¼ 0.010), preoperative PTH (I 2 ¼ 92%, P < 0.0001) and preoperative calcium levels (I 2 ¼ 79%, P < 0.0009), a random-effects model was used for the meta-analyses. According to the heterogeneity for the meta-...…”

“…A total of 23 studies that enrolled 877 356 participants were included for study quality assessment. 3 , 9 , 10 , 15 – 34 The study selection procedure is presented in the flow chart ( Figure 1 ). Of the included studies, three were prospective cohort studies, nine were retrospective cohort studies, 10 were retrospective case studies and one study was a retrospective cross-sectional analysis.…”

“…Of the included studies, three were prospective cohort studies, nine were retrospective cohort studies, 10 were retrospective case studies and one study was a retrospective cross-sectional analysis. 3 , 9 , 10 , 15 – 34 Eight studies were conducted in European countries, 12 in Asian countries and three in the USA. The characteristics of the included studies are presented in Table 1 .…”

Factors Affecting Hypocalcemia in Patients Undergoing Bilateral Total Thyroidectomy

“…Çoğunlukla geçici olarak seyretmekle birlikte kalıcı olabilmektedir (5). Ameliyat sonrası hastaların 6 aydan uzun süre kalsiyum ve D vitamini replasmanına ihtiyaç duyması kalıcı hipokalsemi olarak tanımlanmaktadır (6).…”