Post-thyroidectomy hypocalcemia. Incidence and risk factors (original) (raw)
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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.
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.
2014
The main objective of this study was to identify the incidence of post-thyroidectomy hypocalcemia in patients underwent lobectomy, subtotal thyroidectomy or total thyroidectomy. This randomized trial study was performed from May 2010 to July 2011 among 108 consecutive patients undergoing thyroidectomy. Patients were allocated into 3 groups based on the 3 common type of thyroidectomy. Pre and postoperative serum calcium levels were determined by using standard protocol for all patients. All patients' preoperative serum calcium levels were normal. Post-thyroidectomy hypoglycemia occurred in 0%, 8.3% and 8.3% of patients who underwent total hypocalcemia, subtotal thyroidectomy and lobectomy, respectively, which represents 5.6% of all patients who shown hypocalcemia (P=0.58). Serum calcium levels were fall in 93% patients, however within several days were returned to normal ranges. We did not find a significant relation between the hypocalcemia and thyroidectomy types. We recommende...
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.
Acta medica Iranica, 2014
The main objective of this study was to identify the incidence of post-thyroidectomy hypocalcemia in patients underwent lobectomy, subtotal thyroidectomy or total thyroidectomy. This randomized trial study was performed from May 2010 to July 2011 among 108 consecutive patients undergoing thyroidectomy. Patients were allocated into 3 groups based on the 3 common type of thyroidectomy. Pre and postoperative serum calcium levels were determined by using standard protocol for all patients. All patients' preoperative serum calcium levels were normal. Post-thyroidectomy hypoglycemia occurred in 0%, 8.3% and 8.3% of patients who underwent total hypocalcemia, subtotal thyroidectomy and lobectomy, respectively, which represents 5.6% of all patients who shown hypocalcemia (P=0.58). Serum calcium levels were fall in 93% patients, however within several days were returned to normal ranges. We did not find a significant relation between the hypocalcemia and thyroidectomy types. We recommende...
Polish Journal of Surgery, 2007
The aim of the study was to compare the extent of surgery in removal of thyroid tissue and serum calcium values postoperatively. Material and methods. Between January 1 and December 31, 2005, 987 patients were operated on at our department due to various thyroid disorders. Patients with anaplastic, medullary and high-stage highly-differentiated (TNM>T3, N0, M0) thyroid carcinomas, as well as reoperated individuals, were excluded from the investigation. The patients were divided into three groups, depending on their serum calcium values; thus, the authors distinguished groups with mild (2.0-2.19 mmol/l), moderate (1.8-1.99 mmol/l) and severe hypocalcemia (<1.8 mmol/l). Differences between the groups were assessed by statistical methods (the t-Student's test and the ? 2 test-the STATISTICA software). The value of p<0.05 was accepted as statistically significant. Results. Of 987 surgical patients, 63 (6.4%) were found to have symptomatic or asymptomatic hypocalcemia. The group included 61 females and two males, their mean age being 50.1±12 years. The intensity of clinical symptoms of hypoparathyroidism was positively correlated with serum calcium values and the said symptoms were most clearly seen in patients classified as belonging to group 3 (Ca<1.8 mmol/ l). The most common surgically treated thyroid disease was non-toxic nodular goiter. Hypocalcemia was the most frequent finding in patients operated on due to thyroid carcinoma. In all patients with a mild form of hypocalcemia, the onset of clinical symptoms occurred on postoperative day 2. As it follows from the analysis, there were no statistically significant differences in hypocalcemia prevalence between patients subjected to bilateral exposure of the thyroid lobes and subtotal vs. total thyroidectomy (6 (6.1%) vs 24 (7.1%) patients). On the other hand, a statistically significant difference between the lower prevalence rate of hypocalcemia in unilateral procedures (p<0.001) as compared to bilateral neck explorations (4 (1.4%) vs 59 (8.4%) patients) seems to be logical and physiologically justified. In addition, an element that was found to affect the level of calcium deficit was the number of parathyroid glands identified "in situ". Hence, the prevalence of hypocalcemia increased with a decrease in the number of identified parathyroids (p<0.05). In hypocalcemic patients, hospitalization time ranged from 3 to 11 days, with a mean time of 5.3 days as compared to 3 days in patients without complications. Six months after the surgery and pharmacotherapy, no clinical and biochemical signs of hypocalcemia were noted in the above described group. Conclusions. The risk of hypocalcemia following thyroid surgery is higher in bilateral neck explorations. There are no statistically significant differences in postoperative hypocalcemia between patients subjected to bilateral subtotal vs. total thyroidectomies.
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.
Turkish Journal of Surgery
Objective: Thyroid gland surgery and its surgical complications are situations that a surgeon frequently encounters in his daily practice. In our study, it was aimed to examine the effect of different treatment methods given to patients who underwent thyroidectomy on hypocalcemia. Material and Methods: Three hundred and seventy-one patients who underwent thyroidectomy at Ondokuz Mayıs University Medical Faculty General Surgery clinic between December 2016 and January 2021 were retrospectively included in the study. Parameters such as surgery indications, fine needle aspiration biopsy results, preoperative serum calcium values, type of surgery, serum calcium values at postoperative 1st day and 1st month, postoperative hospital stay, drugs prescribed at discharge, histopathological diagnosis of the patient, and whether there was incidental parathyroidectomy or not were included. Results: Mean age of 371 patients who underwent thyroidectomy was 49 (19-82) years. Total thyroidectomy was...
Clinical and laboratorial correlation of postoperative hypocalcemia after extensive thyroidectomy
Sao Paulo Medical Journal, 1997
The medical records of 84 patients submitted to extensive thyroidectomy from January 1991 to April 1995 were reviewed and the data was analyzed in order to verify a correlation between postoperative laboratories results and physical findings suggestive of hypocalcemia. It was verified that there was hypocalcemia in 51.2 percent of the patients, of which only 18.6 percent presented symptoms. It was concluded that asymptomatic hypocalcemia is frequent in extensive thyroidectomy and a routine screening for serum calcium in the postoperative period following thyroidectomy and calcium reposition must be systematic.
BMC surgery, 2018
Thyroid surgeries are among the most common operations performed in the world. Hypocalcemia following total thyroidectomy is a common complication that is sometimes difficult to correct. The aim of this study is to determine the risk factors for hypocalcemia following total thyroidectomy and their clinical value. From January 2015 through to April 2017, 400 patients were included in this prospective multicenter study. All patients underwent total thyroidectomy due to various thyroid diseases. The following risk factors were analyzed: pre-operative and post-operative biochemical blood parameters, clinical effects and factors related to surgery, the patient, and the disease. Post-operative hypocalcemia developed in 257 patients (64.2%). Of them, 197 patients (76.7%) were diagnosed with asymptomatic hypocalcemia. Clinical symptoms were present in 60 of the 257 patients with hypocalcemia (23.3%). The statistically significant predictors of hypocalcemia were decreased calcium and ionized...