[Hypoparathyroidism and hypocalcemia following thyroid surgery of multinodular goiter. Multivariant study of the risk factors].

BACKGROUND AND OBJECTIVE

The hypoparathyroidism is one of the most important complications in the patients submitted to thyroid surgery. The aim is to analyze across a multivariate statistical analysis the risks factors for the development of transient and permanent hypoparathyroidism following the multinodular goiter (MG) surgery.

PATIENTS AND METHOD

Between 1970 and 1999, 672 thyroidectomies by MG were reviewed. It was considered transient hypoparathyroidism when the calcemia was minor of 7.5 mg/dl or when being minors of 8.5 mg/dl the patient was presenting symptomatology for the hipocalcemia. The hypoparathyroidsm was considered permanent when the calcemia was minor of 8.5 mg/dl to the year of the surgery.

RESULTS

The hypoparathyroidism appeared in 75 patients (11.2%), 20 with symptomatology (3%), persisting like permanent 6 cases (0.9%). The risk factors for the development of this were the hyperthyroidism (p = 0.0370), and the surgical technique (p < 0.00001) (unilateral versus bilateral surgery), persisting in the multivariate analysis both variables. With respect to the permanent hypoparathyroidism, the risk factor was the toxic MG (p = 0.0109), persisting as independent risk factor in the multivariate analysis (RR = 2.3).

CONCLUSIONS

The principal risk factor of permanent hypoparathyroidism in the MG surgery is the presence of hyperthyroidism.