Post-thyroidectomy hypocalcemia exacerbated by chyle leak (original) (raw)
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International journal of health sciences
Hypocalcemia is a common complication after total thyroidectomy due to acute hypoparathyroidsm post-surgery. The incident varies from 7%-69% depends on the surgery center. The management is divided based on the onset and symptoms. Carpal-pedal spasm, seizure, bronchospasms are the emergency symptoms of hypocalcemia that require administration of intravenous calcium. However the management of asymptomatic hypocalcemia with oral calcium, vitamin D and hydrochlorothiazide can be difficult due to wide fluctuations of serum calcium and the risks of complication. Hereby we report a 14-year-old girl with hypocalcemia due to hypoparathyroidsm post modified bilateral radical neck dissection and total thyroidectomy. She had papillary thyroid carcinoma and lymph node metastases. After surgery, she developed classic sign of hypocalcemia, numbness in extremities which progressed to cramps. Physical examination revealed chvostek’s sign. Laboratory examination showed critical value of hypocalc...
Post-thyroidectomy hypocalcemia. Incidence and risk factors
American Journal of Surgery, 1986
Two hundred twenty-one patients undergoing thyroidectomy were analyzed for factors increasing the risk of postoperative hypocalcemia. Eighty-three percent of all patients experienced hypocalcemia postoperatively, with 13 percent requiring some treatment for symptoms. Patients with advanced thyroid cancer, Graves' disease, or other manifestations of preoperative hyperthyroidism had significantly increased rates of hypocalcemia compared with patients with small cancers or benign euthyroid disease. Total thyroidectomy, repeat thyroidectomy, and thyroidectomy plus neck dissection all significantly increased the incidence of permanent hypocalcemia, whereas lobectomy or subtotal thyroidectomy for benign euthyroid disease were low risk operations. Inadvertent excision of more than one parathyroid gland during thyroidectomy also significantly increased the rate of permanent hypocalcemia.
Management of Chyle Leak in the Neck Following Thyroid Cancer Surgery: A Single Center Experience
World Journal of Endocrine Surgery, 2015
Introduction: Surgery for thyroid cancers often necessitates a neck dissection. This is usually a safe procedure, but can be associated with complications. Chyle leak is one such complication, fortunately rare. There is a dearth of literature with regard to the management of chyle leak in the neck. We present a single center experience in the management of chyle leak in the neck, to improve the understanding of its management.
Hypocalcemia after Total Thyroidectomy – A Prospective Study
International Journal of Contemporary Medicine, Surgery and Radiology, 2019
drugs. This study focused on investigating the postoperative hypocalcemia but it was not analyzed due to the compliance of permanent hypocalcemia. The incidence of postoperative hypocalcemia was nearly 27%. In the available literature the incidence of postoperative hypocalcemia was ranging from 30-80%. 17 CONCLUSION Post-thyroidectomy transient hypocalcaemia is a frequent complication which can be prevented with preoperative preparation of patients with extreme caution and preoperative meticulous dissection, prompt identification of parathyroids and postoperative frequent monitoring of serum calcium and early treatment can prevent significant morbidity.
Analysis of the factors that have an effect on hypocalcemia following thyroidectomy
Turkish Journal of Surgery, 2014
The incidence of and risk factors for hypocalcemia following thyroidectomy were evaluated in this study. Material and Methods: One hundred and ninety thyroidectomy patients were evaluated retrospectively for factors that might contribute to postoperative hypocalcemia; age, hyperthyroidism, malignancy, the extent of surgery (total/near total/subtotal thyroidectomy), cervical lymph node dissection, and incidental parathyroidectomy. Results: The rate of transient hypocalcemia/hypoparathyroidism was 19.47%, with a permanent hypoparathyroidism rate of 4.74%. Factors affecting the development of transient hypocalcemia were found as being operated for hyperthyroidism, and use of total thyroidectomy as the surgical method. Total thyroidectomy increased the risk of postoperative hypocalcemia by 3.16 fold. Patients undergoing operations for hyperthyroidism had a 2.3 fold increase, and those undergoing total thyroidectomy had a 3.16 fold risk of postoperative hypocalcemia. Conclusion: Hyperthyroidism surgery and total thyroidectomy lead to a higher risk of developing early postoperative or transient hypocalcemia. According to our results, no significant relationship could be established between any of the study parameters and persistent hypocalcemia.
Hypocalcemia following Thyroid Surgery: Incidence and Prediction of Outcome
World Journal of Surgery, 1998
Postoperative hypocalcemia is a common and most often transient event after extensive thyroid surgery. It may reveal iatrogenic injury to the parathyroid glands and permanent hypoparathyroidism. We prospectively evaluated the incidence of hypocalcemia and permanent hypoparathyroidism following total or subtotal thyroidectomy in 1071 consecutive patients operated during 1990 -1991. We then determined in a cross-sectional study which early clinical and biochemical characteristics of patients experiencing postoperative hypocalcemia correlated with the long-term outcome. Postoperative calcemia under 2 mmol/L was observed in 58 patients (5.4%). In 40 patients hypocalcemia was considered severe (confirmed for more than 2 days, symptomatic or both). At 1 year after surgery five patients (0.5%) had persistent hypocalcemia. We found that patients carried a high risk for permanent hypoparathyroidism if fewer than three parathyroid glands were preserved in situ during surgery or the early serum parathyroid hormone level was < 12 pg/ml, the delayed serum calcium levels < 8 mg/dl, or the delayed serum phosphorus level > 4 mg/dl under oral calcium therapy. When one or more of these criteria are present, long-term follow-up should be enforced to check for chronic hypocalcemia and to avoid its severe complications by appropriate supplement therapy.
The Incidence of Transient and Permanent Hypocalcaemia After Total Thyroidectomy for Thyroid Cancer
International Journal of Endocrinology and Metabolism, 2010
ypocalcaemia is one of the more acute complications of total thyroidectomy and occurs after parathyroid injury during surgery. The aim of this study is to assess the incidence rate and risk factors of transient and permanent hypocalcaemia in patients who had undergone total thyroidectomy, due to malignant thyroid diseases and to determine the value of parathyroid gland autotranplantation in thyroid cancer surgeries. Materials and Methods: Sixty-five patients, diagnosed with thyroid malignancy, who were treated by total thyroidectomy with or without radical neck dissection between 2002 and 2006, were studied retrospectively. Of patients 60% were female (mean age 39.59± ± ± ±10.24 years) and 40% were male (mean age 42.11± ± ± ± 11.93 years). Complications of total thyroidectomy, permanent and transient hypocalcaemia in particular, were studied. In eleven patients, parathyroids were transplanted within fibers of sternocleidomastoid and deltoid muscles. Results: Transient hypocalcaemia occurred in 18 patients and was treated by intravenous and oral calcium supplements. None of patients progressed to permanent hypocalcaemia. Temporary recurrent laryngeal nerve paresis occurred in 2% of patients but there was no case of paralysis. There was a significant difference in hypocalcaemia occurrence between patients, who had just total thyroidectomy and those who underwent thyroidectomyt with neck dissection (p=0.01).
Relevant Correlation between Hypocalcemia and Thyroidectomy Operation: Review Article
The Egyptian Journal of Hospital Medicine
Background: One of the most popular surgical procedures performed worldwide is thyroid surgery, which is regarded as the best solution for benign conditions like multinodular goitre with compressive symptoms and thyroid cancer. The most common side effects of thyroid surgery include postoperative haemorrhage, parathyroid insufficiency, and recurrent laryngeal nerve damage. The removal of the glands during surgery may cause hypoparathyroidism. Following thyroidectomy, hypocalcemia is a common consequence that has a high risk of mortality and has been linked to longer hospital stays, postoperative problems, and higher readmission rates. Objective: Assessment of incidence of hypocalcemia as postoperative complication of thyroidectomy operation. Methods: We searched PubMed, Google Scholar, and Science Direct for information on hypocalcemia with thyroidectomy. However, only the most current or comprehensive study from February 2004 to July 2022 was considered. The authors also assessed references from pertinent literature. Documents in languages other than English have been disregarded since there aren't enough resources for translation. Unpublished manuscripts, oral presentations, conference abstracts, and dissertations were examples of papers that weren't considered to be serious scientific research. Conclusion: A highly effective and simple predictor of hypocalcemia in individuals undergoing total thyroidectomy is the comparison of the post-operative drop in calcium levels to the immediate pre-operative readings.
Post-Thyroidectomy Hypocalcemia: Clinical Study at Tertiary Care Center
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Hypocalcaemia after Total Thyroidectomy
Bangladesh Journal of Otorhinolaryngology
Objective: To determine whether postoperative hypocalcemia after total thyroidectomy is more frequent in malignant disease than benign disease. Methods: This is a Cross sectional study. The sample size is 126. All the patients were selected according to the eligibility criteria by purposive sampling. Patients were analyzed for age, gender, thyroid pathology, preoperative serum calcium, postoperative serum calcium. Results: Postoperative hypocalcemia was found in 37 (29.37%) patients. Most patients were female (Male: Female= 1: 4.2). Patients having low preoperative serum calcium had developed more postoperative hypocalcemia (p<0.03). Postoperative hypocalcemia was associated with thyroid pathology (p<0.009) and age (p<0.006), not associated with sex (p<0.907). In multivariate analysis very little association between malignant disease and postoperative hypocalcemia was found (p<0.07). Conclusion: The incidence of postoperative hypocalcemia following total thyroidectomy...