Digestif Cancer, Digestive and Endocrine Surgery, Institute of Digestive Tract Diseases, Hôtel-Dieu, CHU de Nantes, 44093 Nantes cedex 1, France.
Visceral and Endocrine General Surgery Department, Pitié-Salpêtrière Hospital, Pierre-et-Marie-Curie-Sorbonne University (Paris 6), 75013 Paris, France.
J Visc Surg. 2023 Jun;160(3S):S95-S109. doi: 10.1016/j.jviscsurg.2023.05.004. Epub 2023 May 19.
Postoperative hypoparathyroidism, resulting from removal and/or devascularization of one or more parathyroid glands, is a feared complication of total thyroidectomy. Two forms, which are distinguished by their frequency, their time to onset and their duration as well as by their presentation, must be individualized: early postoperative hypocalcemia, often secondary to early hypoparathyroidism is a frequent and often transient situation occurring within the first days after surgery; permanent hypoparathyroidism, which is rarer, manifests when parathyroid function remains impaired for more than six months after surgery. Because of their severity, these conditions must be known and ideally prevented during total thyroidectomy. The objective of this article is to provide surgeons with practical recommendations for the prevention, diagnosis, and treatment of hypoparathyroidism after total thyroidectomy. These recommendations, which are the fruit of a medico-surgical consensus, were developed by the Francophone Association of Endocrine Surgery (AFCE), the French Society of Endocrinology (SFE) and the French Society of Nuclear Medicine and Molecular Imaging. (SFMN). The content, grade and level of evidence for each recommendation was decided after consultation within a panel of experts, based on an analysis of recent literature.
手术后甲状旁腺功能减退症是由于一个或多个甲状旁腺的切除和/或血供破坏引起的，是甲状腺全切除术后令人恐惧的并发症。两种形式的甲状旁腺功能减退症因其发生频率、发生时间、持续时间以及表现而有所不同：术后早期低钙血症，常继发于早期甲状旁腺功能减退症，是术后最初几天内经常发生且常常是短暂的情况；永久性甲状旁腺功能减退症则较为罕见，当手术后甲状旁腺功能持续受损超过六个月时出现。由于其严重性，在甲状腺全切除术中必须了解并理想地预防这些情况。本文的目的是为外科医生提供预防、诊断和治疗甲状腺全切除术后甲状旁腺功能减退症的实用建议。这些建议是医学和外科共识的成果，由法语内分泌外科协会（AFCE）、法国内分泌学会（SFE）和法国核医学和分子成像学会（SFMN）制定。在一个专家小组内进行咨询后，根据对近期文献的分析，决定了每个建议的内容、等级和证据水平。
