Risk Factors of Hypoparathyroidism Following Total Thyroidectomy for Thyroid Cancer

Paek, Se Hyun; Lee, Young Mi; Min, Sun Young; Kim, Seok Won; Chung, Ki-Wook; Youn, Yeo-Kyu

doi:10.1007/s00268-012-1809-4

Cited by 109 publications

(108 citation statements)

References 37 publications

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“…These cases account for all the procedures of the neck region that resulted in impaired parathyroid function and involved a mean of 1.3/100,000 inhabitants per year during the observation. Overall, the prevalence of postsurgical hypoparathyroidism in previous reports varied according to centers of different expertise and experience [1][2][3][4][5][9][10][11][12][13][14]. The type and extension of surgery of the neck structures and, consequently, the underlying disease, as well as repeated surgeries, can also affect the rate of postoperative hypoparathyroidism [1,11,15].…”

Section: Discussionmentioning

confidence: 99%

The Epidemiology of Hypoparathyroidism in Italy: An 8-Year Register-Based Study

et al. 2016

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Hypoparathyroidism is a rare endocrine disorder, but few studies have focused on the epidemiology and hospital management of the disease and none has been performed in Italy. We investigated the prevalence of different forms of hypoparathyroidism among hospitalized patients in Italy during an 8-year period. This study is designed as a retrospective register-based study. We retrieved data from the ''Record of Hospital Discharge'' (SDO) of the Italian Health Ministry, from the year 2006 to 2013 and analyzed the codes corresponding to hypoparathyroidism-related diagnoses. The inpatient prevalence of the disease was also calculated after excluding repeated hospitalizations. Overall, 27,692 hospitalization episodes for hypoparathyroidism were identified during the entire period (72.2% in women and 27.8% in men; mean age 49.5 ± 22.9 years). The mean length of stay was 7.4 ± 9.8 days (25.9% of the episodes requiring less than 3 days of stay). The mean hospitalization rate for hypoparathyroidism was 5.9/100,000 inhabitants per year and there was a significant decrease during the period of 2006-2013 (p \ 0.0001). The mean hospitalization rate for postsurgical hypoparathyroidism was 1.4/100,000 inhabitants per year and the trend showed a significant reduction during the years (p \ 0.0001). The mean prevalence of hypoparathyroidism among inpatients was 5.3/100,000 inhabitants per year, and there was a significant decrease over the years (p \ 0.0001). Hypoparathyroidism, particularly the postsurgical form of the disease, is not an uncommon condition among hospitalized patients in Italy. We observed a tendency to a decrease in the frequency of hospitalization during the period 2006-2013.

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Section: Discussionmentioning

confidence: 99%

The Epidemiology of Hypoparathyroidism in Italy: An 8-Year Register-Based Study

et al. 2016

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“…Preservation of parathyroid in situ is more physiologically natural, but it is often technically difficult. Paek et al demonstrated that surgeon's skill is an independent risk factor of permanent hypoparathyroidism on multivariate analysis [20]. Only one surgeon (Akira Miyauchi) performed surgery for the series of patients of Kihara et al [1,2].…”

Section: Discussionmentioning

confidence: 99%

Permanent hypoparathyroidism after completion total thyroidectomy as a second surgery: How do we avoid it?

et al. 2014

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A permAnent hypopArAthyroidism is one of the prominent complications of total thyroidectomy. To prevent it, some attempts have been performed such as carefully preserving the parathyroid gland with blood supply [1][2][3] and parathyroid autotransplantation to the sternocleidomastoid muscle or the pectoralis major muscle after mincing [1,2,[4][5][6]. The incidence of permanent hypoparathyroidectomy of total thyroidectomy with and without central dissection was reported to be 0-4.6% [7][8][9] and 0-3.4% [10][11][12], respectively, but one report demonstrated that the incidence increased in reoperation of bilateral central dissection (from 0 to 23%) [13].In this study, we investigated the risk factors of permanent hypoparathyroidism of patients who underwent completion total thyroidectomy as the second surPermanent hypoparathyroidism after completion total thyroidectomy as a second surgery: How do we avoid it?Yasuhiro Ito, Minoru Kihara, Kaoru Kobayashi, Akihiro Miya and Akira Miyauchi Department of Surgery, Kuma Hospital, Kobe 650-0011, JapanAbstract. A permanent hypoparathyroidism is a problematic complication of total thyroidectomy. In this study, we investigated its incidence and how to avoid it at the time of completion total thyroidectomy after hemithyroidectomy. Eight of the 154 patients who underwent completion total thyroidectomy as the second surgery (5%) after hemithyroidectomy (two-surgery group) showed a permanent hypothyroidism. Patients without parathyroid autotransplantation either at initial or second surgery were more likely to show a permanent hypoparathyroidism. In the subset of 74 patients in two-surgery group, who underwent bilateral central dissection, 6 (8%) had a permanent hypoparathyroidism. The incidence was higher than those in control group who underwent total thyroidectomy with bilateral central dissection at one time, which was 2%. However, all 6 patients showing a permanent hypoparathyroidsm underwent bilateral central dissection in initial surgery and none of the patients who underwent bilateral central dissection in twice had a permanent hypoparathyroidism. Taken together, we can conclude that 1) in initial surgery of hemithyroidectomy, we have to carefully search the parathyroid glands and if dissected, they should retrieved and autotransplanted to save the patients from a permanent hypoparathyroidism when they undergo second surgery in future, and 2) hemithyroidectomy with bilateral central dissection significantly increases the risk of permanent hypoparathyroidism and only ipsilateral dissection is better when we do not perform total thyroidectomy.

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“…The most common cause of HPT is inadvertent damage or removal of the parathyroid glands during thyroidectomy [6,8,19,20]. After total thyroidectomy, transient HPT can be observed in as high as 10% of patients.…”

Section: Discussionmentioning

confidence: 99%

Fahr’s Syndrome due to Hypoparathyroidism Following Thyroidectomy

Soares

2013

J Med Cases

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Fahr's syndrome is a rare, degenerative, and neuropsychiatric disorder characterized by seizures, extrapyramidal, and neuropsychiatric symptoms as a result of symmetric and bilateral calcifications of the nucleus pallidus, the putamen, the dentate nucleus of the cerebellum, and the hemispheric white matter at the base of the skull. The female patients, who has 53-year-old, was admitted in the intensive care unit with status epilepticus for 24 hours associated to acute respiratory failure due to aspiration pneumonia. She had undergone a thyroidectomy 22 years ago, when she started involuntary lasting muscular contractions of the upper extremities, which progressed to convulsions throughout the years. There were Chvostek and Trousseau signs. Laboratory tests showed ionic calcium of 0.55 mmol/L. Computed tomography scan of the brain showed intracranial symmetrical calcifications of the basal nuclei, semioval center, occipital, and cerebellar cortex. According to the clinical presentation, examination findings, and subsequent investigation exams, our case was diagnosed as Fahr's syndrome due to post-thyroidectomy hypoparathyroidism. Fahr's syndrome should be considered in patients with neuropsychiatric disturbances and seizure disorder, especially following thyroidectomy.

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Risk Factors of Hypoparathyroidism Following Total Thyroidectomy for Thyroid Cancer

Cited by 109 publications

References 37 publications

The Epidemiology of Hypoparathyroidism in Italy: An 8-Year Register-Based Study

The Epidemiology of Hypoparathyroidism in Italy: An 8-Year Register-Based Study

Permanent hypoparathyroidism after completion total thyroidectomy as a second surgery: How do we avoid it?

Fahr’s Syndrome due to Hypoparathyroidism Following Thyroidectomy

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