scholarly journals Incidence and predictors of post-thyroidectomy hypocalcaemia in a tertiary endocrine surgical unit

2014 ◽  
Vol 96 (3) ◽  
pp. 219-223 ◽  
Author(s):  
O Edafe ◽  
P Prasad ◽  
BJ Harrison ◽  
SP Balasubramanian
Keyword(s):  
Medical Records ◽  
Vitamin D Supplementation ◽  
Hard Copy ◽  
Central Lymph Node ◽  
Central Lymph Node Dissection ◽  
Factors Associated ◽  
Short And Long Term ◽  
Central Lymph ◽  
Surgical Unit

Background Post-thyroidectomy hypocalcaemia is a common complication with significant short and long term morbidity. The aim of this study was to determine the incidence and predictors of post-thyroidectomy hypocalcaemia (as defined by a corrected calcium <2.1 mmol/l) in a tertiary endocrine surgical unit. Methods A total of 238 consecutive patients who underwent completion or bilateral thyroid surgery between 2008 and 2011 were included in this retrospective study. Clinical and biochemical data were obtained from electronic and hard copy medical records. Results The incidence of post-thyroidectomy hypocalcaemia on first postoperative day (POD1) was 29.0%. There was variation in the incidence of hypocalcaemia depending on the timing of measurement on the first postoperative day. At six months following surgery, 5.5% of patients were on calcium and/or vitamin D supplementation. Factors associated with post-thyroidectomy hypocalcaemia were lower preoperative corrected calcium (p=0.005) and parathyroid gland (PTG) auto-transplant (p=0.001). Other clinical factors such as central lymph node dissection, inadvertent PTG excision, ethnicity, preoperative diagnosis and Lugol’s iodine were not associated with post-thyroidectomy hypocalcaemia. Conclusion The incidence of post-thyroidectomy hypocalcaemia was underestimated by 6% when only POD1 measurements were considered. The timing of measurement on POD1 has an impact on the incidence of post-thyroidectomy hypocalcaemia. Auto-transplantation and lower preoperative calcium were associated with post-thyroidectomy hypocalcaemia.

scholarly journals Prophylactic Bilateral Central Neck Dissection Should Be Evaluated Based on Prospective Study of 581 PTC Patients

2021 ◽  
Author(s):  
Shouyi YAN ◽  
Jiafan Yu ◽  
wenxin zhao ◽  
Bo WANG ◽  
Liyong ZHANG
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Test Group ◽  
Control Group ◽  
Node Dissection ◽  
Central Lymph Node ◽  
Central Lymph Node Dissection ◽  
Node Metastasis ◽  
Central Lymph

Abstract Background: Prophylactic central lymph node dissection (PCND) had been a basic consensus for patients with papillary thyroid carcinoma in China. However, unilateral or bilateral central lymph node dissection (CND)was still controversial. This study aimed at investigating the safety and long-term benefit for the patients with bilateral central lymph node dissection (BCCD). Methods: 581 patients were enrolled and divided randomly into the test and control groups according to a different range of CND. 285 patients were prospectively assigned to undergo lobe thyroidectomy plus BCND in the test group, in comparison 296 patients were assigned to undergo lobe thyroidectomy plus ipsilateral central lymph node dissection (ICND) in the control group. Results: We found that the numbers of total LN and N1a in the test group were higher than that of the control group (p=0.002), but there was no difference in the number of metastasized lymph nodes (p=0.857) and tumor recurrence (p=0.308). Additionally, in the aspect of postoperative complication (1 day after surgery), the serum levels of parathyroid hormone in the BCND group were lower than that in the ICND group (P =0.010), and the numbers of transient laryngeal nerve palsy were higher than that(p=0.033). meanwhile we further found that tumors size larger than 1cm and tumor side lymph node metastasis were related to the contralateral lymph node metastasis. Conclusion: BCND resulted in more positive lymph nodes and complications while did not change the patient's long-term prognosis. It may be an alternative for patients with tumor sizes larger than 1cm in large medical centers.

scholarly journals Prophylactic Bilateral Central Neck Dissection Should Be Carefully Evaluated Based on Prospective Study of 581 Cases With cN0 Papillary Thyroid Carcinoma

2021 ◽  
Author(s):  
Shouyi Yan ◽  
Wen Xin Zhao ◽  
Bo Wang ◽  
Liyong Zhang
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Test Group ◽  
Control Group ◽  
Node Dissection ◽  
Central Lymph Node ◽  
Central Lymph Node Dissection ◽  
Node Metastasis ◽  
Central Lymph

Abstract Background: prophylactic central lymph node dissection (PCND) had been a basic consensus for patients with papillary thyroid carcinoma (PTC) in China. However, unilateral or bilateral central lymph node dissection (CND)was still controversial. This study aimed at investigating the safety and long-term benefit for the patients with bilateral central lymph node dissection (BCCD). Methods: 581 patients were enrolled and divided randomly into the test and control groups according to a different range of CND. 285 patients were prospectively assigned to undergo lobe thyroidectomy plus BCND in the test group, in comparison 296 patients were assigned to undergo lobe thyroidectomy plus ipsilateral central lymph node dissection (ICND) in the control group. Results: We found that the numbers of total LN and N1a in the test group were higher than that of the control group (p = 0.002), but there was no difference in the number of metastasized lymph nodes (p = 0.857) and tumor recurrence (p = 0.308). Additionally, in the aspect of postoperative complication (1 day after surgery), the serum levels of parathyroid hormone in the BCND group were lower than that in the ICND group (P = 0.010), and the numbers of transient laryngeal nerve palsy were higher than that(p = 0.033). meanwhile we further found that tumors size larger than 1cm and tumor side lymph node metastasis were related to the contralateral lymph node metastasis. Conclusion: BCND resulted in more positive lymph nodes and similar surgical complications compared with ICND but did not change the patient's long-term prognosis. It may be an alternative for patients with tumor sizes larger than 1cm. Meanwhile, and it should be done in large medical centers, with rich experience in PG and RLN protection

The long term outcome of papillary thyroid carcinoma patients without primary central lymph node dissection: Expected improvement of routine dissection

Surgery ◽  
2009 ◽  
Vol 146 (6) ◽  
pp. 1188-1195 ◽  
Author(s):  
Yasemin Giles (Senyurek) ◽  
Fatih Tunca ◽  
Harika Boztepe ◽  
Faruk Alagöl ◽  
Tarık Terzioglu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Expected Improvement ◽  
Papillary Thyroid ◽  
Node Dissection ◽  
Central Lymph Node ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Central Lymph Node Dissection ◽  
Central Lymph

scholarly journals Analysis of Risk Factors Associated with Outcomes in Road Traffic Injury Patients with Acute Lung Injury

2009 ◽  
Vol 37 (3) ◽  
pp. 835-840
Author(s):  
L Sheng ◽  
J-S Wu ◽  
M Zhang ◽  
S-W Xu ◽  
J-X Gan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Road Traffic ◽  
Road Traffic Injury ◽  
Apache Ii Score ◽  
Factors Associated ◽  
Traffic Injury ◽  
Short And Long Term

Over 50% of road traffic injury (RTI) patients experience post-traumatic acute lung injury (ALI) and it is, therefore, extremely important to identify the risk factors related to the poor outcomes associated with ALI in RTI populations. This study evaluated 19 potential risk factors associated with the outcomes of ALI in 366 RTI patients. They were divided into two groups: a ‘favourable outcomes group’ and an ‘unfavourable outcomes group’. The results indicated that the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the presence of gastrointestinal haemorrhage may help predict the outcomes of ALI in the early post-trauma phase of treatment. The duration of trauma and sepsis were shown to impact strongly on both the short- and long-term outcomes of ALI. Age (≥ 65 years) and disseminated intravascular coagulation in the early RTI phase were also independent risk factors for a poorer short- and long-term outcome in ALI.

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