Severe Hypocalcemia After Thyroidectomy

Kazaure, Hadiza S.; Zambeli-Ljepovic, Alan; Oyekunle, Taofik; Roman, Sanziana A.; Sosa, Julie Ann; Stang, Michael T.; Scheri, Randall P.

doi:10.1097/sla.0000000000003725

Cited by 42 publications

(40 citation statements)

References 43 publications

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“…Postoperative complications included hoarseness, hypocalcemia, choking, chylous leakage, postoperative infection, and so on. While the definition of postoperative hypocalcemia varies widely in literature (16,17), the diagnostic criteria used in this study were: blood calcium level below 2.1 mmol/L 1 week after total thyroidectomy, or the presentation of the following symptoms: muscle pain, muscle weakness, arrhythmia for the first time after surgery, tingling and numbness in the face and limbs, and tendon hyperreflexia; symptoms lasting more than 6 months were considered permanent hypocalcemia. The diagnostic criteria for permanent postoperative hoarseness in this study were: no improvement for more than 6 months and the presence of recurrent laryngeal nerve palsy was supported by laryngoscopy.…”

Section: Surgery and Follow-upmentioning

confidence: 99%

Pathological analysis and surgical modalities selection of cT1N0M0 solitary papillary thyroid carcinoma in the isthmus

Zhang¹,

Xu²,

Ge³

et al. 2021

Gland Surg

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Background: prognosis, identify clinicopathological characteristics, and determine optimal modalities for cT1N0M0 solitary papillary thyroid carcinoma in the isthmus (PTCI). Methods:The clinical data of 124 patients with cT1N0M0 solitary PTCI from 3 medical centers were analyzed retrospectively. Of these, 32 participants had undergone total thyroidectomy plus unilateral central neck dissection, 36 had received total thyroidectomy plus bilateral central neck dissection, 24 had lessthan-total thyroidectomy plus unilateral central neck dissection, and 32 had less-than-total thyroidectomy plus bilateral central neck dissection. We compared the effects of different surgical modalities and clinicopathological characteristics on the prognosis of cT1N0M0 solitary PTCI. Results: There was no significant difference in postoperative recurrence-free survival between participants who received different extents of central region lymph node dissection and thyroidectomies (P>0.05). Temporary hypocalcemia occurred in participants who underwent total thyroidectomy plus bilateral central neck dissection [chi-square (X2) =7.87, P=0.005]. Tumors with primary lesions ≥0.55 cm were prone to have central lymph node metastasis [95% confidence interval (CI): 0.51 to 0.71, P=0.047]. Multiple logistic analysis suggested that age over 55 years [odds ration (OR) =11.90, 95% CI: 1.36 to 104.03, P=0.025], tumor size greater than 0.55 cm (OR =4.16, 95% CI: 1.28 to 13.52, P=0.018), and absence of nodular goiter (OR =2.57, 95% CI: 1.05 to 6.32, P=0.04) were risk factors for central lymph node metastasis of patients with cT1N0M0 solitary PTCI.Conclusions: Less-than-total thyroidectomy is recommended for patients with cT1N0M0 solitary PTCI.Central lymph node dissection is recommended for patients who are prone to have central occult lymph node metastases with tumor size ≥55 cm, older than 55 years, and without nodular goiter.

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Section: Surgery and Follow-upmentioning

confidence: 99%

Pathological analysis and surgical modalities selection of cT1N0M0 solitary papillary thyroid carcinoma in the isthmus

Zhang¹,

Xu²,

Ge³

et al. 2021

Gland Surg

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“…Studies conducted by Sawant et al [14] show that postoperative complications after thyroidectomy affected 14% of the surveyed, while the research carried out by Cipolla et al [15] reports the value of up to 43.8%. Kazaure et al showed that 5.8% of 7366 patients had thyroid hypocalcaemia after thyroidectomy, 83.2% required intravenous calcium therapy [16].…”

Section: Discussionmentioning

confidence: 99%

Quality of life of patients after total and subtotal thyroidectomy

Król

Grochowska

Bodys-Cupak

et al. 2020

Health Prmot Phys Act

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Introduction: Thyroid diseases, especially those that require surgical treatment, are an extremely strong emotional stimulus for the patient. They evoke not only anxiety disorders, but also in the case of complications (especially those long-lasting) can even generate depressive disorders, or significantly affect the patient’s self-esteem, and thus its functioning at the social level. Aim of the study: The objective of the study was to examine the quality of life of patients who underwent surgical treatment of total and subtotal thyroidectomy. Material and methods: The study was conducted in a group of 102 patients undergoing surgery at the General Surgery Ward of the Hospital. St. Łukasz in Tarnów in the period from December 2018 to April 2019, as well as residents of Małopolska, who had performed thyroidectomy. In research have been used ThyPROpl, VAS Scale, and self-prepared questionnaires. Results and conclusions: The most common complications of thyroidectomy were tingling and numbness around the mouth and limbs (42.2%). Patients who had symptoms of tetany had a reduced perception of quality of life and health, as well as the quality of life in all its areas. The respondents had a degraded, reduced quality of life in terms of the negative impact of the disease on life (62.01) and fatigue (56.23). The greater the intensity of pain, the lower the quality of life of patients after thyroidectomy. Conclusions. There is the relationship between the quality of life and the number of complications, as well as the severity of pain. This dependence is directly proportional.

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“…As for thyroid surgery, patients need life-long thyroxine replacement therapy and possibly have abnormal low circulating parathyroid hormone (PTH) levels after surgery, which can lead to disorders of the calcium-phosphate balance ( Jørgensen et al, 2021 ). A study including 7,366 thyroidectomy patients showed that patients with severe hypocalcemia had a higher rate of recurrent laryngeal nerve injury (13.4% vs. 6.6%), unplanned reoperation (4.4% vs. 1.3%), and longer hospitalization (30.4% vs. 6.2%) ( p < 0.01) ( Kazaure et al, 2021 ).…”

Section: Management Of Graves’ Hyperthyroidism and Negative Effectsmentioning

confidence: 99%

New Therapeutic Horizon of Graves’ Hyperthyroidism: Treatment Regimens Based on Immunology and Ingredients From Traditional Chinese Medicine

Gong

Guo

et al. 2022

Front. Pharmacol.

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Graves’ disease is an autoimmune disease characterized by goiter and hyperthyroidism, and 25% patients develop GO. Traditional treatment options, such as antithyroid drugs, radioiodine or thyroidectomy, have remained largely unchanged over the past 70 years. For many patients, there is a high rate of recurrence after antithyroid drugs and lifelong hypothyroidism after ablation and thyroidectomy. The symptoms and quality of life of some patients have not been effectively improved. The clinical demand for new therapeutic regimens, coupled with a deeper understanding of the pathophysiology and immunobiology of Graves’ disease, has led to the emergence of several new therapeutic ideas, including biologics, small molecule peptides, immunomodulators and teprotumumab, a specific antibody targeting IGF-1R. Besides, the elements of TCM have attracted more and more interests in modern medicine, because some effective components have been successfully used in the treatment of autoimmune diseases. Based on the pathophysiology and efficacy of clinical management and treatment in Graves’ hyperthyroidism, here we review the new strategies under investigation and summarize the effective components of traditional Chinese medicine used for Graves’ hyperthyroidism, and explore their mechanisms. These therapies have opened a new window for the treatment of Graves’ disease, but the exact mechanism and the research direction still need to be further explored.

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Severe Hypocalcemia After Thyroidectomy

Cited by 42 publications

References 43 publications

Pathological analysis and surgical modalities selection of cT1N0M0 solitary papillary thyroid carcinoma in the isthmus

Pathological analysis and surgical modalities selection of cT1N0M0 solitary papillary thyroid carcinoma in the isthmus

Quality of life of patients after total and subtotal thyroidectomy

New Therapeutic Horizon of Graves’ Hyperthyroidism: Treatment Regimens Based on Immunology and Ingredients From Traditional Chinese Medicine

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