Risk Factors of Hypoparathyroidism After Thyroidectomy
American Journal of Clinical and Experimental Medicine
Volume 8, Issue 2, March 2020, Pages: 26-30
Received: Feb. 15, 2020;
Published: May 29, 2020
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Zhou Ru, Department of General Surgery, Luwan Branch, Ruijin Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, China
Wang Maofei, Department of General Surgery, Luwan Branch, Ruijin Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, China
Shahabbas Enwer, Department of Preventive Medicine, School of Public Health, Fudan University, Shanghai, China
Yuan Jianming, Department of General Surgery, Luwan Branch, Ruijin Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, China
Wu Weize, Department of General Surgery, Luwan Branch, Ruijin Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, China
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[OBJECTIVE] Persistent hypocalcemia caused by long-term hypoparathyroidism can significantly reduce the living quality of patients. The purpose of this study was to investigate possible factors affecting postoperative hypoparathyroidism. [METHODS] This study retrospective collected thyroid surgery cases from January 2015 to December 2017 in Luwan Branch of Ruijin Hospital Affiliated to Medical College of Shanghai Jiao Tong University. Moreover, we analyzed demographic data, operative data and perioperative examination indexes. Using logistic regression analysis to investigate possible factors affecting postoperative transient/long-term hypoparathyroidism. [RESULTS] Totally, 1381 people were collected, 343 male (24.84%) and 1038 female (75.16%), the average age was 47.9±13.0 years. Postoperative transient hypoparathyroidism occurred in 456 people (33.02%), and long-term hypoparathyroidism in 21 people (1.52%). After multivariate analysis, the main risk factors associated with postoperative transient hypoparathyroidism were gender(P<0.001, OR 0.486), maximum diameter of thyroid resection(P 0.011, OR 1.192), thyroid resection extent (P<0.001, OR 2.974), lymph node dissection(P 0.008, OR 1.569), surgery duration(P 0.034, OR 1.005), preoperative serum calcium(P<0.001, OR 0.028). The main risk factors associated with postoperative long-term hypoparathyroidism were thyroid resection extent (P<0.003, OR 5.443), surgery duration (P 0.021, OR 0.976), postoperative d1PTH (P<0.001, OR 1.199). [CONCLUSIONS] The risk factors for postoperative transient hypoparathyroidism include gender, the extent of thyroid resection, lymph node dissection, duration of surgery and preoperative serum calcium. The extent of resection and duration of surgery were risk factors for postoperative long-term hypoparathyroidism, and PTH on the early morning after surgery(d1PTH) was lower than normal, which had a predictive effect on long-term hypoparathyroidism.
Thyroid Surgery, Hypoparathyroidism, Logistic Regression Analysis
To cite this article
Risk Factors of Hypoparathyroidism After Thyroidectomy, American Journal of Clinical and Experimental Medicine.
Vol. 8, No. 2,
2020, pp. 26-30.
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
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Dionigi G, Baeuzzi A, Bertocchi V, et al．Prospective and surgical usefulness of perioperative parathyroid hormone assay in thyroid surgery [J]. Expert Rev Med Devices, 2008, 5 (6): 699-704.
Dedivitis RA, Aires FT, Cernea CR. Hypoparathyroidism after thyroidectomy: prevention, assessment and management [R]. Curr Opin Otolaryngol Head Neck Surg, 2017, 25 (2): 142–146.
Coimbra C, Monteiro F, Oliveira P, et al. Hypoparathyroidism following thyroidectomy: Predictive factors [J]. Acta Otorrinolaringol Esp. 2017; 68 (2): 106–111.
Caglià P, Puglisi S, Buffone A, et al. Post-thyroidectomy hypoparathyroidism, what should we keep in mind? [R]. Ann Ital Chir, 2017, 6: 371–381.
Almquist M, Ivarsson K, Nordenström E, et al. Mortality in patients with permanent hypoparathyroidism after total thyroidectomy [J]. Br J Surg. 2018; 105 (10): 1313–1318.
Toniato A, BoschinI M, Piotto A, et al. Thyroidectoma and para-thyroid hormone：tracing Hypocalcemia-prone [J]. Am J Surg, 2008, 196 (2): 285-288.
Shoback D. Clinical practice. Hypoparathyroidism [J]. N Engl J Med, 2008, 359 (4): 391-403.
Li Wenjie, XuHaiqian, ZhaiLibin. Parathyroid Micro Vascular Anatomy and Thyroid Lobectomy with Capsular Technique [J]. Chin J Bases Clin General Surg, 2013, 20 (01): 104-107.
Landry CS, Grubbs EG, Hernandez M, et al. Predictable criteria for selective, rather than routine, calcium supplementation following thyroidectomy [J]. Archives of Surgery, 2012, 147 (4): 338.
LvChunhui, Chen Haizhen, ShenXiaohui, et al. Risk factors for hypoparathyroidism after total thyroidectomy [J]. Chin J Gen Surg, 2017, 32 (10): 863-867.
Yin Fengyan, Xing Hao, Zhang Xiaojian, et al. Protective effects of nano-carbon on parathyroid in thyroid surgery [J]. Chin J EndocrSurg, 2015 (2): 144-146.
BaoHaidong, Gong Peng. Risk factors, diagnosis and treatment of hypoparathyroidism after total thyroidectomy [J]. International Journal of Surgery, 2017, 44 (2): 81-84.
Kazaure HS, Sosa JA. Surgical Hypoparathyroidism [R]. Endocrinol Metab Clin North Am, 2018, 47 (4): 783–796.