Iatrogenic hypoparathyroidism after surgery for retrosternal goitre. A single centre retrospective analysis

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Abstract

AIM: The aim of this study is to assess, retrospectively, the incidence of secondary hypoparathyroidism after total thyroidectomy in patients with retrosternal goitre.MATERIAL AND METHODS: From January 2009 to September 2015, 622 patients who undergone total thyroidectomy for goitre, were retrospectively observed. The patients were divided into two group: Group A, including 58 patients with retrosternal goitre and Group B, including 562 patients with in situ goitre. Those patients with diseases of the parathyroid glands, assumption of drugs modifying calcium metabolism and who received blood transfusions before or after surgery, were excluded from the study. In both groups, a total thyroidectomy was performed under general anaesthesia. The upper and lower parathyroid glands in both groups were observed in situ as well. All surgical specimens underwent histological examination.RESULTS: Transient hypocalcaemia was observed in a higher percentage in group A (15% vs 7%, P <0.05). The mean hospital stay was greater in group A (P <0.05). There were no statistically differences between the two groups in terms of permanent hypocalcaemia and post-operative blood ionized calcium (72hours and 1 month).CONCLUSIONS: Many efforts should be made to respect parathyroids during total thyroidectomy in retrosternal goitre; greater attention should be given to inferior parathyroid glands that should be displayed, respecting the vasculature and performing a terminal lower thyroid artery ligation in order to reduce the risk of transient hypocalcaemia and - as a consequence - the average hospital stay.
Original languageEnglish
Pages (from-to)67-70
Number of pages4
JournalDefault journal
Volume169
Publication statusPublished - 2018

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Hypoparathyroidism
Goiter
Thyroidectomy
Parathyroid Glands
Hypocalcemia
Length of Stay
Calcium
Blood Transfusion
General Anesthesia
Ligation
Thyroid Gland
Arteries
Incidence
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{8aeef13c421c41fda0f78bf2f55bc8f0,
title = "Iatrogenic hypoparathyroidism after surgery for retrosternal goitre. A single centre retrospective analysis",
abstract = "AIM: The aim of this study is to assess, retrospectively, the incidence of secondary hypoparathyroidism after total thyroidectomy in patients with retrosternal goitre.MATERIAL AND METHODS: From January 2009 to September 2015, 622 patients who undergone total thyroidectomy for goitre, were retrospectively observed. The patients were divided into two group: Group A, including 58 patients with retrosternal goitre and Group B, including 562 patients with in situ goitre. Those patients with diseases of the parathyroid glands, assumption of drugs modifying calcium metabolism and who received blood transfusions before or after surgery, were excluded from the study. In both groups, a total thyroidectomy was performed under general anaesthesia. The upper and lower parathyroid glands in both groups were observed in situ as well. All surgical specimens underwent histological examination.RESULTS: Transient hypocalcaemia was observed in a higher percentage in group A (15{\%} vs 7{\%}, P <0.05). The mean hospital stay was greater in group A (P <0.05). There were no statistically differences between the two groups in terms of permanent hypocalcaemia and post-operative blood ionized calcium (72hours and 1 month).CONCLUSIONS: Many efforts should be made to respect parathyroids during total thyroidectomy in retrosternal goitre; greater attention should be given to inferior parathyroid glands that should be displayed, respecting the vasculature and performing a terminal lower thyroid artery ligation in order to reduce the risk of transient hypocalcaemia and - as a consequence - the average hospital stay.",
author = "Massimo Cajozzo and Palumbo, {Vincenzo Davide} and {Lo Monte}, {Attilio Ignazio} and Giuseppe Damiano and Gerlando Cocchiara",
year = "2018",
language = "English",
volume = "169",
pages = "67--70",
journal = "Default journal",

}

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T1 - Iatrogenic hypoparathyroidism after surgery for retrosternal goitre. A single centre retrospective analysis

AU - Cajozzo, Massimo

AU - Palumbo, Vincenzo Davide

AU - Lo Monte, Attilio Ignazio

AU - Damiano, Giuseppe

AU - Cocchiara, Gerlando

PY - 2018

Y1 - 2018

N2 - AIM: The aim of this study is to assess, retrospectively, the incidence of secondary hypoparathyroidism after total thyroidectomy in patients with retrosternal goitre.MATERIAL AND METHODS: From January 2009 to September 2015, 622 patients who undergone total thyroidectomy for goitre, were retrospectively observed. The patients were divided into two group: Group A, including 58 patients with retrosternal goitre and Group B, including 562 patients with in situ goitre. Those patients with diseases of the parathyroid glands, assumption of drugs modifying calcium metabolism and who received blood transfusions before or after surgery, were excluded from the study. In both groups, a total thyroidectomy was performed under general anaesthesia. The upper and lower parathyroid glands in both groups were observed in situ as well. All surgical specimens underwent histological examination.RESULTS: Transient hypocalcaemia was observed in a higher percentage in group A (15% vs 7%, P <0.05). The mean hospital stay was greater in group A (P <0.05). There were no statistically differences between the two groups in terms of permanent hypocalcaemia and post-operative blood ionized calcium (72hours and 1 month).CONCLUSIONS: Many efforts should be made to respect parathyroids during total thyroidectomy in retrosternal goitre; greater attention should be given to inferior parathyroid glands that should be displayed, respecting the vasculature and performing a terminal lower thyroid artery ligation in order to reduce the risk of transient hypocalcaemia and - as a consequence - the average hospital stay.

AB - AIM: The aim of this study is to assess, retrospectively, the incidence of secondary hypoparathyroidism after total thyroidectomy in patients with retrosternal goitre.MATERIAL AND METHODS: From January 2009 to September 2015, 622 patients who undergone total thyroidectomy for goitre, were retrospectively observed. The patients were divided into two group: Group A, including 58 patients with retrosternal goitre and Group B, including 562 patients with in situ goitre. Those patients with diseases of the parathyroid glands, assumption of drugs modifying calcium metabolism and who received blood transfusions before or after surgery, were excluded from the study. In both groups, a total thyroidectomy was performed under general anaesthesia. The upper and lower parathyroid glands in both groups were observed in situ as well. All surgical specimens underwent histological examination.RESULTS: Transient hypocalcaemia was observed in a higher percentage in group A (15% vs 7%, P <0.05). The mean hospital stay was greater in group A (P <0.05). There were no statistically differences between the two groups in terms of permanent hypocalcaemia and post-operative blood ionized calcium (72hours and 1 month).CONCLUSIONS: Many efforts should be made to respect parathyroids during total thyroidectomy in retrosternal goitre; greater attention should be given to inferior parathyroid glands that should be displayed, respecting the vasculature and performing a terminal lower thyroid artery ligation in order to reduce the risk of transient hypocalcaemia and - as a consequence - the average hospital stay.

UR - http://hdl.handle.net/10447/285702

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