Störungen des Kalziumstoffwechsels nach Schilddrüsenresektionen. Eine Analyse wesentlicher Einflussfaktoren

Meyer, T.; Merkel, Susanne; Radespiel-Troeger, Martin; Hohenberger, W.

doi:10.1055/s-2002-31972

Cited by 10 publications

(4 citation statements)

References 19 publications

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“…Für die Vermeidung des postoperativen Hypoparathyreoidismus im operativen Vorgehen gibt die Literatur eine Vielzahl von Empfehlungen [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. Bislang fehlen jedoch konkrete Kenntnisse zu Risikofaktoren für den permanenten postoperativen Hypoparathyreoidismus.…”

Section: Diskussionunclassified

Risikofaktoren für den permanenten postoperativen Hypoparathyreoidismus

et al. 2019

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Zusammenfassung Hintergrund Der permanente postoperative Hypoparathyreoidismus ist die häufigste Komplikation nach einer totalen Thyreoidektomie mit erheblichen möglichen Folgeerkrankungen, Beeinträchtigung der Lebensqualität und hoher sozioökonomischer Bedeutung. Zielsetzung Identifikation von Risikofaktoren für den permanenten postoperativen Hypoparathyreoidismus. Material und Methoden 420 Patienten unseres Schilddrüsenzentrums erhielten zwischen 08/2012 und 08/2014 eine totale Thyreoidektomie. 382 gingen in die Studie ein. An einer Follow-up-Untersuchung zwischen 8 und 32 Monaten nach der Operation nahmen 117 teil. Ergebnisse Mit einem permanenten postoperativen Hypoparathyreoidismus waren assoziiert: erniedrigter PTH-Wert am 1. postoperativen Tag, Verzicht bzw. Nichterfordernis einer Redon-Drainage und eine lange Krankenhausverweildauer. Die Assoziationen waren ausgeprägt, jedoch nicht signifikant. Diskussion Wir ermittelten Hinweise auf Prädiktoren für den permanenten postoperativen Hypoparathyreoidismus. Eine Validierung als relevante Risikofaktoren sollte in größeren Multicenterstudien erfolgen. Die Kenntnis von Risikofaktoren könnte zur Vermeidung dieser Komplikation und zur gezielten Nachsorgebetreuung gefährdeter Patienten dienen.

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Section: Diskussionunclassified

Risikofaktoren für den permanenten postoperativen Hypoparathyreoidismus

et al. 2019

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“…Hypoparathyroidism is another feared complication from thyroidectomy occurred due to direct trauma to the parathyroid glands, devascularization of the glands, or complete removal of the glands during the thyroid surgery [8]. The reported incidence varies between 0.4% and 13.8% and is directly correlated with the extent of thyroidectomy [9].…”

Section: Introductionmentioning

confidence: 99%

Experience of thyroid surgery at tertiary referral centers in Jazan Hospitals, Saudi Arabia

Alharbi

Ahmed

2018

IMAS

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BackgroundBenign multinodular goiter (BMNG) is a common disease of the thyroid gland with palpable thyroid nodules that may be detected in 0.8%–1.5% of men and 5.3%–6.4% of women. Three major complications could be detected after total thyroidectomy: hemorrhage, recurrent laryngeal paralysis, and hypoparathyroidism.AimsThe aim of this study was to review and assess the experience of total thyroidectomy in patients with BMNG at tertiary referral centers in Jazan Hospitals, Saudi Arabia.MethodsA retrospective study was conducted on 320 patients diagnosed with BMNG and subjected to primary total thyroidectomy. Operative mortality and major complications [bleeding, recurrent laryngeal nerve (RLN) injury, and hypoparathyroidism] were recorded.ResultsPostoperative hemorrhage was reported in four patients (1.25%). Bilateral RLN injuries occurred in two patients (0.6%), whereas unilateral RLN injuries occurred in nine patients (2.8%). Permanent hypoparathyroidism was diagnosed in three patients (0.9%), while transient hypoparathyroidism occurred in eight patients (2.5%) and improved after 4 months.ConclusionsTotal thyroidectomy represents today the treatment of choice for BMNG. Proper preoperative preparations, meticulous surgical dissection with careful follow-up of patients will improve the surgical results and reduce postoperative complications.

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“…Hypocalcemia following thyroidectomy is a frequent complication with significant morbidity and has been shown to increase hospital stay and readmission rates [1]. Postthyroidectomy hypocalcemia is due to hypoparathyroidism caused by devascularization or inadvertent resection of the parathyroid glands [2].…”

Section: Introductionmentioning

confidence: 99%

PTH after Thyroidectomy as a Predictor of Post-Operative Hypocalcemia

Metere¹,

Biancucci

Natili³

et al. 2021

Diagnostics

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Post-thyroidectomy hypocalcemia is a frequent complication with significant morbidity, and has been shown to increase hospital stay and readmission rates. The evaluation of serum parathyroid hormone (PTH) levels after thyroidectomy represents a reliable method to predict post-thyroidectomy hypocalcemia, but it remains infrequently used. This retrospective study investigates serum PTH values 3 h after thyroidectomy as a predictor of hypocalcemia. In this study, we enrolled 141 patients aged between 27 and 71 years eligible for total thyroidectomy who presented with multinodular goiter, suspicious nodule on cytological examination, Graves’ disease, or toxic multinodular goiter. Three hours after total thyroidectomy, 53 patients (37.6%) showed a reduction in serum PTH. Of these patients 75.5% developed hypocalcemia by 24 h after surgery and 100% were hypocalcemic after 48 h (p < 0.001). There was no significant difference attributable to the different thyroid diseases, nor to the age of the patients. PTH at 3 h after total thyroidectomy accurately predicts post-operative hypocalcemia. The early detection of patients at risk of developing post-operative hypocalcemia allows for prompt supplementation of calcium and Vitamin D in order to prevent symptoms and allows for a safe and timely discharge.

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Störungen des Kalziumstoffwechsels nach Schilddrüsenresektionen. Eine Analyse wesentlicher Einflussfaktoren

Cited by 10 publications

References 19 publications

Risikofaktoren für den permanenten postoperativen Hypoparathyreoidismus

Risikofaktoren für den permanenten postoperativen Hypoparathyreoidismus

Experience of thyroid surgery at tertiary referral centers in Jazan Hospitals, Saudi Arabia

PTH after Thyroidectomy as a Predictor of Post-Operative Hypocalcemia

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