Risk Factors of Postoperative Hypocalcemia after Total Thyroidectomy of Papillary Thyroid Carcinoma Patients.
10.16956/kjes.2016.16.3.70
- Author:
Ji Young SEONG
1
;
Cho Rok LEE
;
Min Jhi KIM
;
Tae Hyung KIM
;
Seul Gi LEE
;
Jung Bum CHOI
;
Eun Jeong BAN
;
Sang Wook KANG
;
Jandee LEE
;
Jong Ju JEONG
;
Kee Hyun NAM
;
Woong Youn CHUNG
;
Cheong Soo PARK
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. khnam@yuhs.ac
- Publication Type:Original Article
- Keywords:
Hypocalcemia;
Risk factors;
Total thyroidectomy;
Papillary thyroid cancer
- MeSH:
Female;
Humans;
Hypocalcemia*;
Incidence;
Lymph Nodes;
Multivariate Analysis;
Neoplasm Metastasis;
Parathyroid Glands;
Parathyroid Hormone;
Risk Factors*;
Thyroid Gland*;
Thyroid Neoplasms*;
Thyroidectomy*;
Thyroiditis;
Vitamin D
- From:Korean Journal of Endocrine Surgery
2016;16(3):70-78
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Postoperative hypocalcemia is a common complication of thyroidectomy. This study evaluated the incidence and predisposing risk factors for postoperative permanent hypocalcemia after total thyroidectomy. METHODS: There were 1,247 consecutive patients undergoing total thyroidectomy and complete treatment and observation for differentiated thyroid cancer between January 2012 to December 2012 who were enrolled in this study. Patients were divided into two groups, those remaining normalcalcemic (Group I-824 pts) and those who had hypocalcemia requiring treatment (Groups II-423 pts). Group II was subdivided into a transient hypocalcemic group (Group IIA-409 pts) and a permanent hypocalcemic group (Group IIB-14 pts). RESULTS: Female gender, thyroiditis, preserved parathyroid number, lateral lymph node metastasis, RAI treatment, preoperative parathyroid hormone and preoperative vitamin D were significantly associated with the development of postoperative hypocalcemia by multivariate analysis. Comparing patients with transient versus permanent hypocalcemia, tumor size and multiplicity were significantly related to the development of permanent hypocalcemia by multivariate analysis. RAI treatment and parathyroid hormone level on the postoperative third day were significantly related to recovery from transient hypocalcemia to normo-calcemia. CONCLUSION: Risk factors of postoperative hypocalcemia were associated with preoperative patient factors and advanced thyroid cancer. Advanced thyroid cancer was a risk factor for permanent hypocalcemia. To prevent postoperative hypocalcemia, we should focus on patient condition and need to preserve parathyroid gland more carefully in thyroid surgery.
