Postoperative hypo parathyroid in patient with total thyroidectomy; a multi-center study

Abstract

Background: Thyroidectomy complications include nerve damage, hypoparathyroidism, and bleeding. Hypoparathyroidism, marked by reduced parathyroid function, is a common complication, leading to low calcium levels and symptoms like muscle cramps. Incidence rates vary. Surgeons must prioritize parathyroid gland identification and protection during surgery to prevent complications and ensure patient well-being. Aim of the study: The aim of this study has been to evaluate the incidence of hypoparathyroidism and clinical manifestations of hypocalcemia after total thyroidectomy. Methods: This retrospective study, spanning 2020-2022 across four different hospital and teaching institutes in various parts of the world, analyzed 350 patients who underwent thyroid gland surgeries, including 350 total thyroidectomies. Focused on postoperative hypoparathyroidism as an early complication. Inclusion criteria involved age (18-85), complete thyroidectomy, and no prior hypoparathyroidism. Exclusion criteria included coexisting medical conditions and pregnancy. Postoperative hypoparathyroidism diagnosis relied on low serum calcium and parathyroid hormone levels within 24 hours. Result: The study examines the characteristics of a population undergoing thyroid surgeries. Among 144 patients, most are aged 60-65 (41.14%), with 86% females. Total thyroidectomy is standard (87.14%), while 12.86% involve lymphadenectomy. PTH levels below 15.0 pg/ml indicate potential hypoparathyroidism, more prevalent in surgeries with lymphadenectomy. Conclusion: This multicenter study highlights a significant incidence of postoperative hypoparathyroidism after total thyroidectomy and decreased parathyroid hormone (PTH) levels. Early detection and management strategies for postoperative hypoparathyroidism are crucial, with routine monitoring of serum PTH levels within 24 hours post-surgery recommended.