Predictive Factors for Postoperative Early Hypocalcemia in Patients Operated by a Focused Surgical Approach for Primary Hyperparathyroidism Due to Solitary Parathyroid Adenoma

IF 0.4 4区 医学 Q4 SURGERY
Fatma Dilek Dellal Kahramanca, Esra Copuroglu, Beril Turan Erdogan, Afra Alkan, Husniye Baser, Didem Ozdemir, Oya Topaloglu, Reyhan Ersoy, Bekir Cakir
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引用次数: 0

Abstract

There are quite a lot of studies investigating preoperative factors that might be used to predict postoperative hypocalcemia (PH) in thyroidectomized patients; however, there are less studies in parathyroidectomized patients, especially in patients who underwent single parathyroid adenoma excision by using the focused surgical approach. In this study, our aim was to determine whether any preoperative clinical, laboratory, or ultrasonographical feature anticipates PH in parathyroidectomized patients due to primary hyperparathyroidism (PHPT). All patients who operated for PHPT between 2019 and 2021 were retrospectively evaluated. Patients undergoing single parathyroidectomy by using the focused surgical approach were included in the study. Demographic, clinical, ultrasonography, and histopathology results were noted and compared in patients with and without early PH within 4 days after surgery. Of 181 parathyroidectomized patients, 98 underwent focused parathyroidectomy for single parathyroid adenoma. PH was observed in 36 (36.7%) patients. Patients with PH were younger compared to without PH (p = 0.018). Gender distribution and the presence of osteoporosis were comparable. Nephrolithiasis was less prevalent in the hypocalcemia group (p = 0.034). Preoperative levels of calcium, phosphorus, magnesium, parathyroid hormone, alkaline phosphatase, and 25 OH vitamin D were similar in the two groups. Fractional excretion of calcium (FECa) was lower in the PH group (p = 0.045, p = 0.001). Ultrasonographic and histopathologic diameters and volumes of parathyroid lesions were not different in both groups (p > 0.05 for all). In the multivariate analysis, only being 50.5 years old or younger and without nephrolithiasis were found to be associated with PH (p = 0.016, p = 0.026). Patients younger than 50.5 age and without nephrolithiasis might require closer follow-up for the development of early PH.

采用聚焦手术方法治疗甲状旁腺单发腺瘤所致原发性甲状旁腺功能亢进症患者术后早期低钙血症的预测因素
有很多研究都在调查可用于预测甲状腺切除术患者术后低钙血症(PH)的术前因素,但针对甲状旁腺切除术患者的研究却较少,尤其是采用聚焦手术方法切除单发甲状旁腺腺瘤的患者。在这项研究中,我们的目的是确定因原发性甲状旁腺功能亢进症(PHPT)而接受甲状旁腺切除术的患者在术前是否有任何临床、实验室或超声波特征可预示PH。我们对2019年至2021年期间因PHPT而接受手术的所有患者进行了回顾性评估。研究纳入了采用聚焦手术方法进行单次甲状旁腺切除术的患者。研究人员记录并比较了术后4天内有早期PH和无早期PH患者的人口统计学、临床、超声和组织病理学结果。在181名接受甲状旁腺切除术的患者中,98人因单发甲状旁腺腺瘤接受了聚焦甲状旁腺切除术。36名患者(36.7%)出现了PH。与无PH的患者相比,有PH的患者更年轻(P = 0.018)。性别分布和是否患有骨质疏松症具有可比性。低钙血症组的肾炎发病率较低(p = 0.034)。两组患者术前的钙、磷、镁、甲状旁腺激素、碱性磷酸酶和 25 OH 维生素 D 水平相似。PH组的钙排泄率(FECa)较低(P = 0.045,P = 0.001)。两组甲状旁腺病变的超声和组织病理学直径和体积没有差异(均为0.05)。在多变量分析中,只有年龄在50.5岁或以下且无肾结石的患者才与PH相关(p = 0.016,p = 0.026)。年龄小于 50.5 岁且无肾结石的患者可能需要更密切的随访,以防出现早期 PH。
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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
412
审稿时长
6-12 weeks
期刊介绍: The Indian Journal of Surgery is the official publication of the Association of Surgeons of India that considers for publication articles in all fields of surgery. Issues are published bimonthly in the months of February, April, June, August, October and December. The journal publishes Original article, Point of technique, Review article, Case report, Letter to editor, Teachers and surgeons from the past - A short (up to 500 words) bio sketch of a revered teacher or surgeon whom you hold in esteem and Images in surgery, surgical pathology, and surgical radiology. A trusted resource for peer-reviewed coverage of all types of surgery Provides a forum for surgeons in India and abroad to exchange ideas and advance the art of surgery The official publication of the Association of Surgeons of India 92% of authors who answered a survey reported that they would definitely publish or probably publish in the journal again The Indian Journal of Surgery offers peer-reviewed coverage of all types of surgery. The Journal publishes Original articles, Points of technique, Review articles, Case reports, Letters, Images and brief biographies of influential teachers and surgeons. The Journal spans General Surgery, Pediatric Surgery, Neurosurgery, Plastic Surgery, Cardiothoracic Surgery, Vascular Surgery, Rural Surgery, Orthopedic Surgery, Urology, Surgical Oncology, Radiology, Anaesthesia, Trauma Services, Minimal Access Surgery, Endocrine Surgery, GI Surgery, ENT, Colorectal Surgery, surgical practice and research. The Journal provides a forum for surgeons from India and abroad to exchange ideas, to propagate the advancement of science and the art of surgery and to promote friendship among surgeons in India and abroad. This has been a trusted platform for surgons in communicating up-to-date scientific informeation to the community.
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