Abstract
To evaluate the incidence and predictors of post-thyroidectomy definitive hypocalcemia and hypoparathyroidism. We assessed ionic calcium preoperatively and postoperatively (first, second and 30th day) in 333 patients undergoing thyroidectomy. In those presenting hypocalcemia, measurements were also made 90 and 180 days after surgery, when parathormone was also dosed. Patients were grouped according to the presence or absence of hypocalcemia and evaluated according to age, gender, thyroid function, thyroid volume, number of parathyroid glands identified and need to parathyroid reimplantation, type of operation, operative time, and histopathological diagnosis. The incidence of temporary hypocalcemia was 40.8% (136 patients), and of definitive hypoparathyroidism 4.2% (14 patients). Reoperation or total thyroidectomy, neck dissection, hyperthyroidism, operative time and age above 50 years were factors related to higher incidence of hypocalcemia and definitive hypoparathyroidism (p <0.05). predictors of postoperative hypocalcemia included age (> 50 years), total thyroidectomy, reoperation, neck dissection and operative time. The predictors of post-thyroidectomy definitive hypoparathyroidism included type of operation, histological diagnosis and hyperthyroidism.
Highlights
IntroductionThe literature review shows considerable variation in the incidence of post-thyroidectomy hypocalcaemia[2,3,4], with the majority of cases secondary to temporary hypoparathyroidism, with recovery in three weeks to six months
Thyroidectomies have low rates of complications and acceptable sequelae that, can be uncomfortable and disabling[1].The literature review shows considerable variation in the incidence of post-thyroidectomy hypocalcaemia[2,3,4], with the majority of cases secondary to temporary hypoparathyroidism, with recovery in three weeks to six months
Many factors may be involved in the increased incidence of hypocalcemia and hypoparathyroidism after thyroidectomy, including total thyroidectomy, reoperation, neck dissection, preoperative hyperthyroidism and surgical procedure performed by inexperienced surgeons[5,6]
Summary
The literature review shows considerable variation in the incidence of post-thyroidectomy hypocalcaemia[2,3,4], with the majority of cases secondary to temporary hypoparathyroidism, with recovery in three weeks to six months. 0% to 33% of patients will experience permanent hypoparathyroidism[3]. Many factors may be involved in the increased incidence of hypocalcemia and hypoparathyroidism after thyroidectomy, including total thyroidectomy, reoperation, neck dissection, preoperative hyperthyroidism and surgical procedure performed by inexperienced surgeons[5,6]. Not all patients with these factors will develop such complication, probably because in order for it to happen, concur other causes, whose identification seems fundamental to its prevention. This study aims to evaluate the incidence of postthyroidectomy hypocalcaemia, its evolution in six months and the factors involved with hypocalcemia (clinical and laboratorial) and with definitive hypoparathyroidism
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