Permanent hypoparathyroidism following total thyroidectomy - Incidence and preventative strategies without imaging adjuncts.

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-01-09 DOI:10.1016/j.amjsurg.2025.116196

Anita Niu, Lydia Zhou, Alexander Papachristos, Hazel Serrao-Brown, Adam Aniss, Mark Sywak, Stan Sidhu

{"title":"Permanent hypoparathyroidism following total thyroidectomy - Incidence and preventative strategies without imaging adjuncts.","authors":"Anita Niu, Lydia Zhou, Alexander Papachristos, Hazel Serrao-Brown, Adam Aniss, Mark Sywak, Stan Sidhu","doi":"10.1016/j.amjsurg.2025.116196","DOIUrl":null,"url":null,"abstract":"Introduction: Permanent hypoparathyroidism (pHypoPT) is the most common permanent complication of total thyroidectomy. We aim to describe the incidence and predictors of hypoparathyroidism in a consecutive series of patients treated in a high-volume centre and define strategies to reduce the risk of pHypoPT.Methods: 1182 patients who underwent total thyroidectomy between April 2018 and June 2022 were analyzed. Temporary hypoparathyroidism (tHypoPT) was defined as PTH <0.4 pmol/L (<4 pg/mL) at day one post-operatively, or clinical or biochemical evidence of hypocalcemia. pHypoPT was defined as an ongoing need for calcitriol supplementation to maintain normocalcemia at 12 months. Symptomatic tHypoPT (OR 43.97, p < 0.001) and number of parathyroid glands in the operative specimen (OR 2.31, p = 0.022) were also significantly associated with pHypoPT.Results: Biochemical tHypoPT occurred in 205 (17.4 %) patients whilst pHypoPT occurred in 6 (0.5 %) patients. On multivariate analysis, parathyroid auto-transplantation (PA) independently reduced the risk of pHypoPT (OR 0.04, p = 0.004).Conclusions: The risk of pHypoPT after total thyroidectomy is 0.5 % when performed by high-volume surgeons. PA represents an important technique that reduces the risk of pHypoPT.","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116196"},"PeriodicalIF":2.7000,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amjsurg.2025.116196","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Permanent hypoparathyroidism (pHypoPT) is the most common permanent complication of total thyroidectomy. We aim to describe the incidence and predictors of hypoparathyroidism in a consecutive series of patients treated in a high-volume centre and define strategies to reduce the risk of pHypoPT.

Methods: 1182 patients who underwent total thyroidectomy between April 2018 and June 2022 were analyzed. Temporary hypoparathyroidism (tHypoPT) was defined as PTH <0.4 pmol/L (<4 pg/mL) at day one post-operatively, or clinical or biochemical evidence of hypocalcemia. pHypoPT was defined as an ongoing need for calcitriol supplementation to maintain normocalcemia at 12 months. Symptomatic tHypoPT (OR 43.97, p < 0.001) and number of parathyroid glands in the operative specimen (OR 2.31, p = 0.022) were also significantly associated with pHypoPT.

Results: Biochemical tHypoPT occurred in 205 (17.4 %) patients whilst pHypoPT occurred in 6 (0.5 %) patients. On multivariate analysis, parathyroid auto-transplantation (PA) independently reduced the risk of pHypoPT (OR 0.04, p = 0.004).

Conclusions: The risk of pHypoPT after total thyroidectomy is 0.5 % when performed by high-volume surgeons. PA represents an important technique that reduces the risk of pHypoPT.

查看原文本刊更多论文

甲状腺全切除术后永久性甲状旁腺功能减退-无影像学辅助的发病率和预防策略。

永久性甲状旁腺功能减退症（pHypoPT）是全甲状腺切除术最常见的永久性并发症。我们的目的是描述在大容量中心连续治疗的一系列患者甲状旁腺功能低下的发病率和预测因素，并确定降低pHypoPT风险的策略。方法：对2018年4月至2022年6月期间接受甲状腺全切除术的1182例患者进行分析。暂时性甲状旁腺功能减退症（tHypoPT）定义为PTH。结果：生化tHypoPT 205例（17.4%），pHypoPT 6例（0.5%）。在多变量分析中，甲状旁腺自体移植（PA）独立降低pHypoPT的风险（OR 0.04, p = 0.004）。结论：大容量外科医生在全甲状腺切除术后发生pHypoPT的风险为0.5%。PA是一种降低pHypoPT风险的重要技术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.