Incidental extirpation of the parathyroid glands at thyroid surgery: risk factors and post-operative hypocalcemia

2010 ◽  
Vol 268 (7) ◽  
pp. 1047-1051 ◽  
Author(s):  
Ghazi Raji Qasaimeh ◽  
Sabah Al Nemri ◽  
Abdul Kareem Al Omari
Keyword(s):  
Risk Factors ◽  
Thyroid Surgery ◽  
Parathyroid Glands

scholarly journals Risk factors of developing the hungry bone syndrome after parathyroidectomy for primary hyperparathyroidism

2018 ◽  
Vol 25 (1) ◽  
pp. 45-51
Author(s):  
Matas Jakubauskas ◽  
Virgilijus Beiša ◽  
Kęstutis Strupas
Keyword(s):  
Risk Factors ◽  
Primary Hyperparathyroidism ◽  
Retrospective Analysis ◽  
Roc Curve ◽  
Thyroid Surgery ◽  
Final Analysis ◽  
Parathyroid Glands ◽  
Hungry Bone Syndrome ◽  
Definition Of ◽  
Hungry Bone

Background. Around 13% of patients undergoing parathyroidectomy for primary hyperparathyroidism (PHPT) postoperatively develop a condition known as the hungry bone syndrome (HBS). Although the condition is quite prevalent, the research in this field is very limited. The aim of our study was to determine possible risk factors of developing HBS after parathyroidectomy for PHPT. Materials and methods. In this study we enrolled patients who underwent parathyroidectomy for PHPT from January 2005 to December 2016 and performed a retrospective analysis. We used the definition of HBS as hypocalcaemia with normal or elevated PTH values. Patients were divided into two groups by the postoperative HBS prevalence: patients with postoperative HBS and those without postoperative HBS. Results. In all, 94 patients were included into the final analysis. We found that patients who developed HBS more often underwent parathyroidectomies simultaneously with a thyroid surgery, underwent longer operations (73.9 ± 41.7 vs. 102.4 ± 44.8 minutes; p = 0.001), and had heavier parathyroid glands removed (0.6 (0.3–8.0) vs. 0.8 (0.15–14.0) g; p = 0.041). Also, these patients had higher preoperative PTH values (15.3 (6.1–63.7) vs. 22.4 (9.2– 47.8) pmol/l; p = 0.003). From the ROC curve of the preoperative PTH values and the development of the hungry bone syndrome (AUC = 0.721 (95% CI 0.59–0.85); p = 0.003) we found a 45 pmol/l PTH cut-off value that shows a 90% tendency to develop postoperative HBS. Conclusions. Patients undergoing longer parathyroidectomies and those with heavier removed parathyroid glands tend to develop HBS. A preoperative PTH value higher than 45 pmol/l determines an over 90% risk of developing HBS.

Prospective Multicentric Evaluation Studies for Analysis of Surgical Risk Factors in Thyroid Surgery

2010 ◽  
Vol 82 (6) ◽  
Author(s):  
Henning Dralle ◽  
Andreas Machens ◽  
Carsten Sekulla ◽  
Kerstin Lorenz ◽  
Ingo Gastinger ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thyroid Surgery ◽  
Evaluation Studies ◽  
Surgical Risk

scholarly journals Risk factors for postoperative morbidity after thyroid surgery in a PROSPECTIVE cohort of 1500 patients

2021 ◽  
Vol 88 ◽  
pp. 105922
Author(s):  
Sam Van Slycke ◽  
Klaas Van Den Heede ◽  
Niels Bruggeman ◽  
Hubert Vermeersch ◽  
Nele Brusselaers
Keyword(s):  
Risk Factors ◽  
Thyroid Surgery ◽  
Prospective Cohort ◽  
Postoperative Morbidity

Spare Parathyroid Glands During Thyroid Surgery with Perioperative Autofluorescence Imaging: A Diagnostic Study

2021 ◽  
Author(s):  
Alexandre Bellier ◽  
Yann Wazne ◽  
Thibaut Chollier ◽  
Nathalie Sturm ◽  
Philippe Chaffanjon
Keyword(s):  
Thyroid Surgery ◽  
Parathyroid Glands ◽  
Diagnostic Study ◽  
Autofluorescence Imaging

Post-thyroidectomy bleeding: analysis of risk factors from a national registry

2021 ◽  
Author(s):  
H E Doran ◽  
S M Wiseman ◽  
F F Palazzo ◽  
D Chadwick ◽  
S Aspinall
Keyword(s):  
Risk Factors ◽  
Total Thyroidectomy ◽  
Thyroid Surgery ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Bleeding Risk ◽  
Redo Surgery ◽  
Day Case ◽  
Increased Risk ◽  
Male Sex

Abstract Background Post-thyroidectomy haemorrhage occurs in 1–2 per cent of patients, one-quarter requiring bedside clot evacuation. Owing to the risk of life-threatening haemorrhage, previous British Association of Endocrine and Thyroid Surgeons (BAETS) guidance has been that day-case thyroidectomy could not be endorsed. This study aimed to review the best currently available UK data to evaluate a recent change in this recommendation. Methods The UK Registry of Endocrine and Thyroid Surgery was analysed to determine the incidence of and risk factors for post-thyroidectomy haemorrhage from 2004 to 2018. Results Reoperation for bleeding occurred in 1.2 per cent (449 of 39 014) of all thyroidectomies. In multivariable analysis male sex, increasing age, redo surgery, retrosternal goitre and total thyroidectomy were significantly correlated with an increased risk of reoperation for bleeding, and surgeon monthly thyroidectomy rate correlated with a decreased risk. Estimation of variation in bleeding risk from these predictors gave low pseudo-R2 values, suggesting that bleeding is unpredictable. Reoperation for bleeding occurred in 0.9 per cent (217 of 24 700) of hemithyroidectomies, with male sex, increasing age, decreasing surgeon volume and redo surgery being risk factors. The mortality rate following thyroidectomy was 0.1 per cent (23 of 38 740). In a multivariable model including reoperation for bleeding node dissection and age were significant risk factors for mortality. Conclusion The highest risk for bleeding occurred following total thyroidectomy in men, but overall bleeding was unpredictable. In hemithyroidectomy increasing surgeon thyroidectomy volume reduces bleeding risk. This analysis supports the revised BAETS recommendation to restrict day-case thyroid surgery to hemithyroidectomy performed by high-volume surgeons, with caution in the elderly, men, patients with retrosternal goitres, and those undergoing redo surgery.

scholarly journals Fluorescence Image-Guided Surgery for Thyroid Cancer: Utility for Preventing Hypoparathyroidism

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3792
Author(s):  
Marco Stefano Demarchi ◽  
Barbara Seeliger ◽  
Jean-Christophe Lifante ◽  
Pier Francesco Alesina ◽  
Frédéric Triponez
Keyword(s):  
Thyroid Cancer ◽  
Fluorescence Imaging ◽  
Thyroid Surgery ◽  
Parathyroid Glands ◽  
Review Of The Literature ◽  
Inclusion Criteria ◽  
Fluorescence Image ◽  
Guided Surgery ◽  
Fluorescence Guided Surgery

Background: Hypoparathyroidism is one of the most frequent complications of thyroid surgery, especially when associated with lymph node dissection in cases of thyroid cancer. Fluorescence-guided surgery is an emerging tool that appears to help reduce the rate of this complication. The present review aims to highlight the utility of fluorescence imaging in preserving parathyroid glands during thyroid cancer surgery. Methods: We performed a systematic review of the literature according to PRISMA guidelines to identify published studies on fluorescence-guided thyroid surgery with a particular focus on thyroid cancer. Articles were selected and analyzed per indication and type of surgery, autofluorescence or exogenous dye usage, and outcomes. The Methodological Index for Non-Randomized Studies (MINORS) was used to assess the methodological quality of the included articles. Results: Twenty-five studies met the inclusion criteria, with three studies exclusively assessing patients with thyroid cancer. The remaining studies assessed mixed cohorts with thyroid cancer and other thyroid or parathyroid diseases. The majority of the papers support the potential benefit of fluorescence imaging in preserving parathyroid glands in thyroid surgery. Conclusions: Fluorescence-guided surgery is useful in the prevention of post-thyroidectomy hypoparathyroidism via enhanced early identification, visualization, and preservation of the parathyroid glands. These aspects are notably beneficial in cases of associated lymphadenectomy for thyroid cancer.

Pediatric thyroidectomy in a high volume thyroid surgery center: Risk factors for postoperative hypocalcemia

2015 ◽  
Vol 50 (8) ◽  
pp. 1316-1319 ◽  
Author(s):  
Yufei Chen ◽  
Peter T. Masiakos ◽  
Randall D. Gaz ◽  
Richard A. Hodin ◽  
Sareh Parangi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thyroid Surgery ◽  
High Volume ◽  
Postoperative Hypocalcemia ◽  
Surgery Center

scholarly journals Risk factors for post-thyroidectomy haemorrhage: a meta-analysis

2017 ◽  
Vol 176 (5) ◽  
pp. 591-602 ◽  
Author(s):  
Jinhao Liu ◽  
Wei Sun ◽  
Wenwu Dong ◽  
Zhihong Wang ◽  
Ping Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Neck Dissection ◽  
Thyroid Surgery ◽  
Meta Analysis ◽  
Older Age ◽  
Graves Disease ◽  
Malignant Tumours ◽  
Antithrombotic Agents ◽  
Increased Risk ◽  
Male Sex

BackgroundPost-thyroidectomy haemorrhage is a rare but potentially life-threatening and unpredictable complication of thyroid surgery. In this study, we analysed the potential risk factors for the occurrence of post-thyroidectomy haemorrhage.MethodsThe PubMed and SCIE databases were comprehensively searched for studies published before June 30, 2016. Studies on patients who underwent an open thyroidectomy with or without neck dissection were included, and RevMan 5.3 software was used to analyse the data.ResultsTwenty-five studies and 424 563 patients were included in this meta-analysis, and post-thyroidectomy haemorrhage occurred in 6277 patients (incidence rate = 1.48%). The following variables were associated with an increased risk of post-thyroidectomy haemorrhage: older age (MD = 4.30, 95% CI = 3.09–5.52,P < 0.00001), male sex (OR = 1.73, 95% CI = 1.54–1.94,P < 0.00001), Graves’ disease (OR = 1.76, 95% CI = 1.44–2.15,P < 0.00001), antithrombotic agents use (OR = 1.96, 95% CI 1.55–2.49,P < 0.00001), bilateral operation (OR = 1.71, 95% CI = 1.50–1.96,P < 0.00001), neck dissection (OR = 1.53, 95% CI = 1.11–2.11,P = 0.01) and previous thyroid surgery (OR = 1.62, 95% CI = 1.12–2.34,P = 0.01). Malignant tumours (OR = 1.07, 95% CI = 0.89–1.28,P = 0.46) and drainage device use (OR = 1.27, 95% CI = 0.74–2.18,P = 0.4) were not associated with post-thyroidectomy haemorrhage.ConclusionOur systematic review identified a number of risk factors for post-thyroidectomy haemorrhage, including older age, male sex, Graves’ disease, antithrombotic agents use, bilateral operation, neck dissection and previous thyroid surgery. Early control of modifiable risk factors could improve patient outcomes and satisfaction.

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