Risk Factors for Low Levels of Parathyroid Hormone after Surgery for Thyroid Cancer: A Single Center Study
| Autor: | Alessio Volpicelli, Ileana Fazio, Francesca Privitera, Matteo Angelo Cannizzaro, Massimiliano Veroux, Maria Teresa Cannizzaro, Salvatore Costa, Rossella Gioco |
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| Rok vydání: | 2021 |
| Předmět: |
Parathyroidectomy
endocrine system lobectomy medicine.medical_specialty medicine.medical_treatment Parathyroid hormone incidental parathyroidectomy hypocalcemia Article thyroid cancer parathyroid hormone Medicine Thyroid cancer business.industry Thyroidectomy Retrospective cohort study Neck dissection General Medicine lymph node medicine.disease Surgery Dissection female Hypoparathyroidism thyroidectomy central neck dissection business hormones hormone substitutes and hormone antagonists |
| Zdroj: | Journal of Clinical Medicine Journal of Clinical Medicine, Vol 10, Iss 4113, p 4113 (2021) Volume 10 Issue 18 |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm10184113 |
| Popis: | Background: Thyroidectomy is the definitive treatment for most patients with thyroid cancer. Hypoparathyroidism is the most frequent complication of thyroidectomy, and its pathogenesis is multifactorial. The aim of this study is to evaluate the patient- and surgical-related risk factors for hypoparathyroidism after surgery for thyroid cancer. Methods: In this retrospective study, patients referred to surgery for thyroid cancer from 2016 to 2019 were enrolled. Preoperative serum calcium and parathyroid hormone (PTH) and postoperative 24 h PTH and calcium levels were evaluated. Demographic data, type of surgery, incidence of hypoparathyroidism and hypocalcemia were recorded for all the patients. Patients were divided into two groups based on post-operative PTH levels (≤12 and > 12 pg/mL). Results: A total of 189 patients were enrolled in this study. There were 146 women (87.3%) and 43 men (22.7%), with a mean age of 51.3 years. A total of 79 patients (41.7%) underwent a neck dissection. A total of 59 patients (31.1%) had a postoperative PTH level < 12 pg/mL. Female sex, neck dissection, the yield of lymph node dissection and incidental parathyroidectomy were significantly associated with postoperative hypoparathyroidism. Incidental parathyroidectomy was reported in 44 (23.2%) patients and was correlated with younger age (< 40 years) and neck dissection. There was no difference in the rate of post-operative hypocalcemia between patients with incidental parathyroidectomy and those without. Conclusions: Young patients undergoing neck dissection and with incidental parathyroidectomy have the highest risk of postoperative hypoparathyroidism after surgery for thyroid cancer. However, a large proportion of patients without incidental parathyroidectomy may have temporary hypocalcemia, suggesting that impaired blood supply of parathyroid glands during their identification and dissection may play a relevant role. |
| Databáze: | OpenAIRE |
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