Necessity of therapy for post-thyroidectomy hypocalcaemia: a multi-centre experience

Langenbeck's Archives of Surgery
L De PasqualeV Testa

Abstract

Hypoparathyroidism is one of the most common and most feared complications of total thyroidectomy (TT). The aim of this study is to detect possible markers that may facilitate early tracing of hypocalcaemia-prone patients in order to reduce clinical cost by optimizing patient discharge and to avoid unnecessary treatment. Over an 18-month period, 995 patients, 23 % male and 77 % female, aged 52.9 ± 13.4 years, underwent TT in ten Lombardy hospitals. The following parameters were analyzed: calcaemia before and 12-24 and 48 h after surgery, pre- and post-operative parathyroid hormone (PTH) at 24 h and pre-operative 25OH vitamin D. Mortality was nil and morbidity was 22.4 %. Mean 24-h calcaemia and PTH were 2.17 ± 0.15 mmol/l and 31.81 ± 20.35 pg/ml, respectively; mean 24-h PTH decay was 36.7 ± 34.12 %. Four hundred seventy-three (47.5 %) patients were hypocalcaemic at discharge; 142 of whom had transient hypoparathyroidism that became permanent in 27. Patients developing hypocalcaemia had significantly higher values of PTH and calcium decay. At multiple logistic regression, only 24-h calcium decay, PTH drop and the presence of symptoms and parathyroid auto-grafting were significantly related to hypoparathyroidism. The association ...Continue Reading

References

Jan 20, 2005·Surgery·Celestino Pio LombardiRocco Bellantone
May 10, 2008·American Journal of Surgery·Antonio ToniatoPaola Sartori
Aug 24, 2010·The British Journal of Surgery·A Sitges-SerraJ J Sancho
Dec 15, 2010·World Journal of Surgery·James Kirkby-BottFausto Palazzo
Apr 18, 2012·Archives of Surgery·Leigh Delbridge
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Jan 10, 2014·The British Journal of Surgery·O EdafeS P Balasubramanian

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Citations

Mar 5, 2016·The British Journal of Surgery·J Järhult, K Landerholm
Jun 25, 2017·Updates in Surgery·Matteo Angelo CannizzaroAntonino Buffone
Jan 15, 2019·Langenbeck's Archives of Surgery·Giulia ManziniTheresia Weber
Oct 5, 2017·Updates in Surgery·Luca Panier SuffatLodovico Rosato
Feb 6, 2021·Journal of Clinical Medicine·Antonio Sitges-Serra
Aug 18, 2021·Annales d'endocrinologie·Florian FangetJean-Christophe Lifante
Sep 27, 2021·Updates in Surgery·Alberto Maria SaibeneLoredana De Pasquale
Oct 28, 2021·Deutsches Ärzteblatt International·Stephanie SonnenbergAndreas Zielke

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