Objective:To investigate the relationship between parathyroid hormone（PTH） level and permanent hypoparathyroidism（PHPP） on the first day after radical papillary thyroidectomy, and its predictive value. Methods:A total of 80 patients with papillary thyroid cancer who underwent total thyroid resection and central lymph node dissection were collected and analyzed from January 2021 to January 2022. According to whether PHPP occurred after surgery, the patients were divided into hypoparathyroidism group and normal parathyroid function group, and univariate and binary logistics regression were used to analyze the correlation between PTH and serum calcium levels and PHPP on the first day after surgery in two groups. The dynamic changes of PTH at different time points after operation were analyzed. The area under the receiver operating characteristic was used to evaluate the predictive power of PTH on the development of PHPP after surgery. Results:Among the 80 patients with papillary thyroid cancer, 10 cases developed PHPP, with an incidence rate of 12.5%. Binary logistics regression analysis showed that PTH on the first postoperative day（OR=14.534, 95%CI: 2.377-88.858, P=0.004） was an independent predictive risk factor for postoperative PHPP. Taking PTH=8.75 ng/L on the first postoperative day as the cut-off value, the AUC of the area under the curve was 0.874（95%CI: 0.790-0.958, P<0.001）, the sensitivity was 71.4%, the specificity was 100%, and the Yoden index was 0.714. Conclusion:PTH level on the first day after total thyroid papillary carcinoma surgery is closely related to PHPP, and is an independent predictor of PHPP.
Humans ; Calcium ; Hypoparathyroidism/surgery* ; Parathyroid Glands ; Parathyroid Hormone ; Postoperative Complications/surgery* ; Thyroid Cancer, Papillary/surgery* ; Thyroid Neoplasms/complications* ; Thyroidectomy

To investigate the risk factors for hypoparathyroidism after thyroidectomy.
 Methods: Clinical data of 492 patients, who underwent thyroidectomy from April 2015 to December 2016 from Xiangya Hospital of Central South University, were studied retrospectively. Chi-square test and multivariable logistic regression were performed to find the risk factors for postoperative hypoparathyroidism.
 Results: The incidence of postoperative hypoparathyroidism was 43.5%, and the incidence of temporary and permanent hypoparathyroidism was 43.1% and 0.4%, respectively. Univariate analysis showed that tumor pathology, thyroidectomy types, the extent of lymph node dissection, application of carbon nanoparticles, and merged Hashimoto's thyroiditis were risk factors for postoperative hypoparathyroidism (all P<0.01). Logistic regression analysis showed that: thyroidectomy types (OR=0.149, 95% CI 0.078 to 0.28), the extent lymph node dissection (OR=0.779, 95% CI 0.617 to 0.983) and application of carbon nanoparticles (OR=1.729, 
95% CI 1.067 to 2.801) were independent risk factors for postoperative hypoparathyroidism (all P<0.05).
 Conclusion: Hypoparathyroidism is a common complication after thyroidectomy. The incidence of postoperative hypoparathyroidism is significantly increased in patients underwent total thyroidectomy and cervical lymph node dissection. Application of carbon nanoparticles intraoperatively can reduce the incidence of postoperative hypoparathyroidism.
Humans ; Hypoparathyroidism ; surgery ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms ; Thyroidectomy

PURPOSE: The use of sealing devices such as Harmonic scalpel and Ligasure is increasing steadily in thyroid surgery. The Harmonic Focus (HF) is an ultrasonic device that enables simultaneous vessel sealing and tissue coagulation, designed for open surgery such as thyroidectomy. The aim of this study is to assess the efficiency and safety of HF use in thyroid surgery compared to Conventional Tying (CT). METHODS: A prospective study was conducted to compare the efficacy of HF versus CT. We evaluated 50 patients who underwent surgery for thyroid tumor at Korea University Anam Hospital. All patients underwent total thyroidectomy with central neck dissection after being randomly allocated into two groups: HF group and CT group. The differences in surgical outcomes and postoperative complications by device use, i.e. group assignment, were statistically analyzed. RESULTS: There were no differences in number of retrieved lymph nodes (P=0.595), number of resected parathyroid glands (P=0.330), immediate postoperative iPTH (P=0.252), length of hospitalization (P=0.375) between HF group and CT group. However, operative time was shorter in HF group than CT group (106.07±20.92 min vs. 136.54±38.24 min, P=0.046). Postoperative complications of wound infection, seroma, hematoma, chyle leakage, vocal cord palsy, and hypoparathyroidism did not differ between groups. CONCLUSION: HF is a safe, effective, and time-saving technique; outcomes are comparable with CT. Both intraoperative and postoperative variables were similar between groups. Future larger studies are warranted to further investigate the effect on postoperative complications.
Chyle ; Hematoma ; Hospitalization ; Humans ; Hypoparathyroidism ; Korea ; Lymph Nodes ; Neck Dissection* ; Neck* ; Operative Time ; Parathyroid Glands ; Postoperative Complications ; Prospective Studies ; Seroma ; Thyroid Gland ; Thyroidectomy* ; Ultrasonics ; Vocal Cord Paralysis ; Wound Infection

No abstract available.
Basal Ganglia Diseases/diagnostic imaging/drug therapy/*etiology ; Calcinosis/diagnostic imaging/drug therapy/*etiology ; Calcium/therapeutic use ; Dietary Supplements ; Female ; Humans ; Hypoparathyroidism/*complications/diagnosis/drug therapy ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome ; Vitamin D/therapeutic use

Dilated cardiomyopathy (DCM) is usually an idiopathic disease with a poor prognosis. Hypocalcemia is a rare and reversible cause of DCM. Here, we report a 50-year-old female with DCM, induced by idiopathic hypoparathyroidism, that improved after treatment with calcium.
Calcium/administration & dosage ; Cardiomyopathy, Dilated/diagnosis/*etiology/physiopathology ; Dietary Supplements ; Electrocardiography ; Female ; Humans ; Hypocalcemia/diagnosis/drug therapy/*etiology ; Hypoparathyroidism/*complications/diagnosis/drug therapy ; Middle Aged ; Recovery of Function ; Treatment Outcome ; Vitamin D/administration & dosage

Adult ; Female ; Humans ; Hypoparathyroidism ; complications ; congenital ; drug therapy ; Recurrence ; Seizures ; etiology

BACKGROUND AND OBJECTIVES: The harmonic scalpel using the ultrasonic energy is able to grasp and divide tissue while sealing small vessels in narrow operating fields. The aim of the present study was to evaluate the usefulness of the harmonic scalpel in thyroid surgery. MATERIALS AND METHODS: This study was performed for 247 patients who underwent thyroidectomy. According to the use of harmonic Scalpel, the patients could be divided into two groups: the conventional technique (CT) group of knot tying and the harmonic scalpel (HS) group. RESULTS: For hemithyroidectomy, operation time and hospital stay were shorter in the HS group compared with the CT group (p<0.05). For total thyroidectomy with central neck dissection (CND), operation time, total drainage volume, drain removal date, and hospital stay were significantly reduced in the HS group (p<0.05). Among the patients who underwent total thyroidectomy with CND with the HS, one patient (2.9%) showed transient recurrent laryngeal nerve palsy. Transient hypoparathyroidism showed significantly lower incidence in the HS group (p<0.05). CONCLUSION: HS might be cost-effective by reducing operation time and hospital stay without increased postoperative complications.
Drainage ; Hand Strength ; Humans ; Hypoparathyroidism ; Incidence ; Length of Stay ; Neck Dissection ; Postoperative Complications ; Thyroid Gland ; Thyroidectomy ; Ultrasonics ; Vocal Cord Paralysis

PURPOSE: The study investigated clinical features of patients who underwent thyroid surgery, with and without Hashimoto's thyroiditis. METHODS: We retrospectively reviewed the medical records of 150 patients who underwent thyroid surgery at the Department of Surgery, Wallace Memorial Baptist Hospital, between January 2007 and December 2008. Patients were divided into two groups according to occurrence or non-occurrence of Hashimoto's thyroiditis, and analyzed them for age, sex, day of hospitalization, duration of drain keeping, operation time, and post-operative complications, including recurrent laryngeal nerve injuries, hypoparathyroidism, hypocalcemia, and adjacent structure injury. There were 24 lobectomies and 126 total thyroidectomies. RESULTS: Operation time was longer for patients with Hashimoto's thyroiditis. There was little difference between the two groups with respect to day of hospitalization, duration of draining, or post-operative complications. Of the total thyroidectomy cases without Hashimoto's thyroiditis, 36 patients (37.5%) had transient hypocalcemia and four (4.2%) had permanent hypocalcemia. Of the cases with Hashimoto's thyroiditis, 13 patients (38.2%) had transient hypocalcemia and three (8.8%) had permanent hypocalcemia. Patients undergoing thyroid surgery with Hashimoto's thyroiditis had longer operation times due to increased angiogenesis and fibrosis. No difference was shown for other clinical features or post-operative complications. CONCLUSION: The data strongly indicate that meticulous hemostasis and careful surgical technique, along with an understanding of anatomic variation and surgical experience, leads to a low late of complications following thyroid surgery, even for patients with Hashimoto's thyroiditis.
Anatomic Variation ; Fibrosis ; Hemostasis ; Hospitalization ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Medical Records ; Postoperative Complications ; Protestantism ; Recurrent Laryngeal Nerve Injuries ; Retrospective Studies ; Thyroid Gland* ; Thyroidectomy* ; Thyroiditis*

The aim of this study was to investigate the complications following surgical treatment of thyroid cancer and the association between the extent of surgery and complication rates. A total of 2,636 patients who underwent surgery due to thyroid cancer were retrospectively reviewed to identify surgical complications. Complication rates were assessed according to the extent of surgery, which was classified as follows; less-than-total thyroidectomy with central compartment node dissection (CCND) (Group I, n=636), total thyroidectomy with CCND (Group II, n=1,390), total thyroidectomy plus ipsilateral neck dissection (Group III, n=513), and total thyroidectomy plus bilateral neck dissection (Group IV, n=97). The most common surgical complication was symptomatic hypoparathyroidism, of which 28.4% of cases were transient and 0.3% permanent. The other surgical complications included vocal cord palsy (0.7% transient, and 0.2% permanent), hematoma (0.5%), seroma (4.7%), chyle fistula (1.8%), and Horner's syndrome (0.2%). The complication rates increased significantly with increasing the extent of surgery from Group I to Group IV. The more extensive surgery makes more complications, such as hypoparathyroidism, seroma, and others.
Adult ; Female ; Humans ; Hypoparathyroidism/etiology ; Male ; Middle Aged ; Paralysis/etiology ; Parathyroid Glands/surgery ; *Postoperative Complications ; Retrospective Studies ; Seroma/etiology ; Thyroid Neoplasms/*complications/pathology/*surgery

BACKGROUNDParathyroid hormone deficiency or resistance may cause hypocalcemia with related symptoms and signs. Lifelong treatment of calcium combined with vitamin D or its metabolites is always necessary for these patients. Here we reported a prospective and open-label trial to investigate the efficacy and safety of domestic-made calcitriol in treatment of hypocalcemia caused by hypoparathyroidism or pseudohypoparathyroidism.

METHODSTwenty-four patients with confirmed hypoparathyroidism or pseudohypoparathyroidism aged (36.5 +/- 11.0) years old were studied. Among them, 16 patients had idiopathic hypoparathyroidism, 2 had pseudohypoparathyroidism and 6 had hypoparathyroidism secondary to cervical surgery. Serum calcium levels were lower than 1.88 mmol/L. Oral calcitriol was administered twice or three times with elemental calcium 1.2 g per day. All patients were followed every 4 weeks throughout the 12-week period. Dose adjustments of calcitriol were based on serum and urinary calcium levels and symptoms of hypocalcemia.

RESULTSTwenty patients were included by the end of this study. Muscular weakness, cramps, extremity paresthesia, Chovestek's sign and Trousseau's sign were relieved in 76.9%, 100%, 94.4%, 93.3% and 78.9% of patients, respectively. Serum calcium, plasma ionized calcium and serum phosphorus levels were (1.54+/-0.25) mmol/L, (0.64+/-0.10) mmol/L and (2.00+/-0.46) mmol/L at baseline, and reached (2.20+/-0.20) mmol/L, (0.95+/-0.06) mmol/L and (1.68+/-0.25) mmol/L (P<0.01) at the 12th week of treatment, respectively. Eighty percent of patients were assessed as effective and 20% as partly effective. Three, four and eight patients had hypercalciuria at the 4th, 8th and 12th week of treatment, respectively, which were reduced by thiazide diuretics. The final dose of calcitriol was (1.09+/-0.50) microg/d.

CONCLUSIONSCalcitriol combined with calcium can be used in treatment of hypocalcemia caused by hypoparathyroidism or pseudohypoparathyroidism effectively and safely. Serum and urinary calcium levels should be monitored during the course of the therapy.

Adult ; Calcitriol ; adverse effects ; therapeutic use ; Calcium ; blood ; urine ; Female ; Humans ; Hypocalcemia ; blood ; drug therapy ; etiology ; urine ; Hypoparathyroidism ; blood ; complications ; urine ; Male ; Middle Aged ; Prospective Studies ; Pseudohypoparathyroidism ; blood ; complications ; urine