Persistent hypoparathyroidism following thyroidectomy: Analysis of 276 patients.

Abstract

ABSTRACT Aim: To explore the attributes of individuals who have developed permanent hypoparathyroidism following thyroidectomy.Method: A 276 cases diagnosed with permanent hypoparathyroidism (PHP) after thyroid surgery were evaluated retrospectively.Results: 98% had total thyroidectomy, 70% had no lymph node dissection, 13% operated by endocrine surgeons, and 24% by an experienced surgeon. In 85% of the patients, PHP developed after their first operation. 63% of the patients had benign disease. No parathyroid glands were found on the final pathology report in 68% of the cases. The operations were performed at university hospitals in 20% of patients. Central lymph node dissections (CLND) were conducted on 27% of patients. Among these, 59% were performed by surgeons with under 5 years of experience.Conclusion: The onset of PHP after bilateral thyroidectomy is influenced by a myriad of factors. Our study observed a trend linking the likelihood of developing PHP to the surgeon’s specialization, experience, the extent of surgery, operations performed in non-academic hospitals, and the conduct of CLND. Notably, even when performed by experienced surgeons, CLND might elevate the risk of this complication. This trend underscores the need for greater awareness about the implications of PHP. Emphasizing surgeon specialization and experience could be an instrumental role in reducing the incidence of this multifaceted complication.