The prevalence of hypoparathyroidism after thyroid surgery depending on the diagnosis, the extent of the procedure, and the presence of parathyroid glands in the postoperative examination

Lorek, Andrzej; Steinhof-Radwańska, Katarzyna; Zarębski, Wojciech; Barczyk-Gutkowska, Anna; Lorek, Joanna; Stojčev, Zoran; Pasek, Jarosław; Szyluk, Karol

doi:10.5603/ep.a2021.0080

Cited by 1 publication

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“…Permanent hypoparathyroidism, defined as a persistent need for vitamin D and/or calcium supplementation at one year postoperatively, is related to increased long-term morbidity and mortality [75,76]. The frequency of permanent hypoparathyroidism ranges between 1,9%-12.5% [77][78][79][80][81]. Among independent risk factors for permanent postoperative hypoparathyroidism, incidental parathyroidectomy, the extent of thyroid surgery, surgeon experience, age above 60, and female gender were reported [77,79,82].…”

Section: Controversies Related To "Less Is More" In Primary Thyroid S...mentioning

confidence: 99%

Lobo-isthmectomy in the management of differentiated thyroid cancer

et al. 2023

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We have recently witnessed a rapid increase in the incidence of differentiated thyroid carcinoma (DTC), particularly low and very low-risk papillary thyroid carcinoma. Simultaneously, the number of cancer-related deaths has remained stable for more than 30 years. Such an indolent nature and long-term survival prompted researchers and experts to an ongoing discussion on the adequacy of DTC management to avoid, on the one hand, the overtreatment of low-risk cases and, on the other hand, the undertreatment of highly aggressive ones.The most recent guidelines of the American Thyroid Association (ATA GL) moved primary thyroid surgery in DTC towards a less aggressive approach by making lobectomy an option for patients with intrathyroidal low-risk DTC tumors up to 4 cm in diameter without evidence of extrathyroidal extension or lymph node metastases. It was one of the key changes in DTC management proposed by the ATA in 2015.Following the introduction of the 2015 ATA GL, the role of thyroid lobectomy in DTC management has slowly become increasingly important. The data coming from analyses of the large databases and retrospective studies prove that a less extensive surgical approach, even if in some reports it was related to a slight increase of the risk of recurrence, did not show a negative impact on disease-specific and overall survival in T1T2N0M0 low-risk DTC. There is no doubt that making thyroid lobectomy an option for low-risk papillary and follicular carcinomas was an essential step toward the de-escalation of treatment in thyroid carcinoma.This review summarizes the current recommendations and evidence-based data supporting the necessity of de-escalation of primary thyroid surgery in low-risk DTC. It also discusses the controversies raised by introducing new ATA guidelines and tries to resolve some open questions.

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