Risk factors of permanent hypoparathyroidism after total thyroidectomy and central neck dissection for papillary thyroid cancer: a prospective study.

Endokrynologia Polska
Paulina GodlewskaMarek Dedecjus

Abstract

Inadvertent removal of, or damage to the parathyroid glands in the course of operations on the anterior neck compartment are responsible for over 80% of cases of chronic hypoparathyroidism (HypoPT). This study searched for factors related to the development of permanent HypoPT after total thyroidectomy and central neck lymphadenectomy in patients with thyroid carcinoma. In total, 89 of 103 screened patients met the study's criteria and were put under prospective one-year observation. Demographic and surgical factors as well as the biochemical parameters of mineral homeostasis, controlled both preoperatively and postoperatively, were subject to statistical analysis. In line with contemporary guidelines, postoperative hypocalcaemia, rather than an abnormally low serum parathormone (PTH) concentration, was considered a diagnostic criterion of HypoPT. On postoperative day one (POD1), serum concentration of PTH decreased below the normal range (< 12 pg/mL) in 29 patients and was undetectable in 19 patients (< 6 pg/mL). At one year postoperatively, 12 patients with undetectable POD1 PTH required treatment for hypocalcaemia and were diagnosed with permanent hypoPT. All the other patients regained normocalcaemia. Relative risk of perma...Continue Reading

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