Transient hypoparathyroidism following thyroidectomy: A prospective study and multivariate analysis of 604 consecutive patients

Cavicchi, Ottavio; Piccin, Ottavio; Caliceti, Umberto; Cataldis, Angelo De; Pasquali, Renato; Ceroni, Alberto Rinaldi

doi:10.1016/j.otohns.2007.03.001

Cited by 100 publications

(79 citation statements)

References 17 publications

(47 reference statements)

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“…One may argue that male patients might present a more difficult situs, thus the longer duration of surgery. However, the current literature does not suggest the male gender to be a risk factor for the development of hypocalcemia following thyroidectomy [29].…”

Section: Discussionmentioning

confidence: 81%

Prolonged duration of surgery is not a risk factor for postoperative complications in patients undergoing total thyroidectomy: a single center experience in 305 patients

et al. 2014

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Background: Hypocalcemia and nerve injury are the most severe complications after thyroid surgery. The duration of surgery has not been previously considered as a risk factor for postoperative complications in patients undergoing total thyroidectomy. We sort to investigate the influence of prolonged surgery on postoperative complications in patients undergoing total thyroidectomy. Methods: We hypothesized that a threshold of > 120 minutes of surgical time could represent a surrogate marker for postoperative complications in patients undergoing total thyroidectomy for benign thyroid disorders. The study population was divided into two groups based on the median duration of surgery (120 min): group I ≤ 120 minutes (control group), group II > 120 minutes (study group). The charts of eligible patients undergoing total thyroidectomy within a six-year period from January 1 st 2006 to December 31 st 2012 were reviewed. The primary outcomes included the rates postoperative hypocalcemia and recurrent laryngeal nerve palsy. The secondary outcomes included the rates of postoperative hemorrhage, wound dehiscence and length of hospital stay. Results: 305 cases of thyroidectomy were included for analysis; 130 (42.6%) control group and 175 (57.4%) study group. Transient (15.4% vs 19.4%) and permanent (3.8% vs. 2.9%) hypocalcemia were recorded in control and study group respectively. The incidence of nerve palsy was 1.5% in the control group and 1.4% in the study group. The mean length of postoperative hospital stay was 3d in both groups. There was no significant difference amongst both groups with regard to postoperative bleeding (p = 0.57) and wound dehiscence (p = 0.31). Prolonged surgery (> 120 min) was not identified as a risk factor for increased postoperative complication. Conclusion: Prolonged duration of surgery > 120 minutes is not a surrogate marker for postoperative complications in patients undergoing total thyroidectomy.

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Section: Discussionmentioning

confidence: 81%

Prolonged duration of surgery is not a risk factor for postoperative complications in patients undergoing total thyroidectomy: a single center experience in 305 patients

et al. 2014

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“…These decreases in CND patients may been because of the greater vulnerability of parathyroid glands caused by the more extensive exploration in the central neck compartment, which may cause a high probability of unplanned parathyroidectomy or parathyroid gland devascularization. 9 We previously demonstrated that the risk of transient hypocalcemia was higher when CND was added to total thyroidectomy, whereas the risk of permanent hypocalcemia did not differ significantly in patients with and without CND. 8 The results reported here are similar, in that transient hypercalcemia developed in 44.0% of CND patients, but the rate of Table 3.…”

Section: Discussionmentioning

confidence: 91%

“…6 Central neck dissection (CND) may prevent central neck recurrence, but bilateral CND is associated with significant morbidity, especially postoperative hypoparathyroidism. [7][8][9] Despite being selflimiting in most patients, symptomatic hypocalcemia is of particular concern because of its delayed manifestation and the consequent need for prolonged patient hospitalization or readmission.…”

mentioning

confidence: 99%

Prevention of postoperative hypocalcemia with routine oral calcium and vitamin D supplements in patients with differentiated papillary thyroid carcinoma undergoing total thyroidectomy plus central neck dissection

Roh

Park

2009

Cancer

145

109

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“…Cavicchi O et al, conducted a study whose purpose was to identify the risk factors for postoperative transient hypoparathyroidism in a group of patients undergoing thyroid surgery. 7 A prospective study was conducted on 604 patients undergoing thyroid surgery. Gender, final diagnosis, extent of resection, biology of pathology, intrathoracic involvement, surgery for recurrent multinodular goiter, and presence and number of parathyroid glands in a surgical specimen were analyzed as risk factors for postoperative transient hypoparathyroidism.…”

Section: Discussionmentioning

confidence: 99%

The number of parathyroid glands preserved during thyroidectomy and relationship between hypoparathyroidism

et al. 2017

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Background: The aim of the study was to determine the number of parathyroid glands that need to be preserved to prevent hypoparathyroidism and to understand the relation between the number of parathyroid glands preserved and hypoparathyroidism.Methods: A retrospective study was performed on 350 patients who had undergone trans cervical total thyroidectomy with or without neck dissection for papillary thyroid carcinoma between July 2010 to August 2015.Results: Incidental parathyroidectomy occurred in 19.1% of patients, one parathyroid gland in 17.8%, two in 2% and 3 in 0.5%. Transient hypoparathyroidism increased when incidental parathyroidectomy occurred on multivariate regression analysis, but it was not influenced by the actual number of parathyroid glands removed. There was no relationship between the number of parathyroid glands preserved and hypoparathyroidism.Conclusions: It is not compulsorily required to prevent permanent hypoparathyroidism, but the preservation of all the four parathyroid glands during thyroidectomy decreases the incidence of transient hypoparathyroidism. When auto transplantation is not performed, to prevent permanent hypoparathyroidism, preserving at least one parathyroid gland with an intact blood supply is sufficient.

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Transient hypoparathyroidism following thyroidectomy: A prospective study and multivariate analysis of 604 consecutive patients

Abstract: The extent of surgery to central and/or lateral neck lymph nodes is responsible for a high rate of transient hypoparathyroidism owing to a high probability of unplanned parathyroidectomy or parathyroid gland devascularization.

Cited by 100 publications

References 17 publications

Prolonged duration of surgery is not a risk factor for postoperative complications in patients undergoing total thyroidectomy: a single center experience in 305 patients

Prolonged duration of surgery is not a risk factor for postoperative complications in patients undergoing total thyroidectomy: a single center experience in 305 patients

Prevention of postoperative hypocalcemia with routine oral calcium and vitamin D supplements in patients with differentiated papillary thyroid carcinoma undergoing total thyroidectomy plus central neck dissection

The number of parathyroid glands preserved during thyroidectomy and relationship between hypoparathyroidism

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