Time to parathyroid function recovery in patients with protracted hypoparathyroidism after total thyroidectomy
| Autor: | Inés Villarroya-Marquina, Leyre Lorente-Poch, Juan J. Sancho, Lander Gallego-Otaegui, Antonio Sitges-Serra |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Hypoparathyroidism Endocrinology Diabetes and Metabolism 030230 surgery Cohort Studies Parathyroid Glands 03 medical and health sciences Postoperative Complications 0302 clinical medicine Endocrinology Endocrinologia Internal medicine Humans Medicine Hypocalcaemia Postoperative Period Prospective Studies Thyroid Neoplasms Tiroide -- Cirurgia Adverse effect Prospective cohort study Thyroid cancer Aged Total thyroidectomy Goiter Tiroide -- Malalties business.industry Recovery of Function General Medicine Middle Aged medicine.disease Surgery Parathyroid Hormone 030220 oncology & carcinogenesis Cohort Thyroidectomy Calcium Female business Follow-Up Studies Cohort study |
| Zdroj: | European Journal of Endocrinology. 178:103-111 |
| ISSN: | 1479-683X 0804-4643 |
| Popis: | Objective Hypocalcaemia is the most common adverse effect after total thyroidectomy. It recovers in about two-thirds of the patients within the first postoperative month. Little is known, however, about recovery of the parathyroid function (RPF) after this time period. The aim of the present study was to investigate the time to RPF in patients with protracted (>1 month) hypoparathyroidism after total thyroidectomy. Design Cohort prospective observational study. Methods Adult patients undergoing total thyroidectomy for goitre or thyroid cancer. Cases with protracted hypoparathyroidism were studied for RPF during the following months. Time to RPF and variables associated with RPF or permanent hypoparathyroidism were recorded. Results Out of 854 patients undergoing total thyroidectomy, 142 developed protracted hypoparathyroidism. Of these, 36 (4.2% of the entire cohort) developed permanent hypoparathyroidism and 106 recovered: 73 before 6 months, 21 within 6–12 months and 12 after 1 year follow-up. Variables significantly associated with RPF were the number of parathyroid glands remaining in situ (not autografted nor inadvertently resected) and a serum calcium concentration >2.25 mmol/L at one postoperative month. Late RPF (>6 months) was associated with surgery for thyroid cancer. RPF was still possible after one year in patients with four parathyroid glands preserved in situ and serum calcium concentration at one month >2.25 mmol/L. Conclusions Permanent hypoparathyroidism should not be diagnosed in patients requiring replacement therapy for more than six months, especially if the four parathyroid glands were preserved. |
| Databáze: | OpenAIRE |
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