Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, 222 Wangsimni-Ro, Seongdong-Gu, Seoul, 04763, Republic of Korea.
Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.
Langenbecks Arch Surg. 2023 Aug 7;408(1):298. doi: 10.1007/s00423-023-03038-5.
The incidence and risk factors for hypoparathyroidism after total thyroidectomy is well-known. However, the characteristics of hypoparathyroidism and hypocalcemia after hemithyroidectomy have not been investigated well. In this study, we aimed to evaluate the incidence, characteristics, and risk factors of hypoparathyroidism and hypocalcemia after hemithyroidectomy.
We retrospectively analyzed the medical data of 321 patients who underwent hemithyroidectomy, with or without central neck dissection, from January 2012 to April 2019. We analyzed the serum intact parathyroid hormone (iPTH), calcium, and ionized calcium (iCa) levels serially (preoperatively and postoperatively on the operation day; days 1 and 3; and months 1, 3, 6, and 12) and evaluated risk factors for postoperative hypoparathyroidism and hypocalcemia.
The mean iPTH and calcium levels decreased significantly after hemithyroidectomy on the operation day and postoperative days 1 and 3, and returned to the preoperative level at the postoperative 1-month follow-up. The mean iCa level decreased significantly on the operation day and postoperative day 1. Transient hypoparathyroidism and transient hypocalcemia occurred in 16 (5%) and 250 (78%) participants, and they recovered to normal levels postoperatively by 1 month. Eight (2.5%) patients had mild symptoms of hypocalcemia necessitating oral calcium supplementation. No permanent hypoparathyroidism or hypocalcemia was observed. Preoperatively low serum iPTH and calcium levels were associated with transient hypoparathyroidism and hypocalcemia after hemithyroidectomy.
Approximately 5% and 2.5% of participants showed transient hypoparathyroidism and mild symptomatic hypocalcemia after hemithyroidectomy. The risk factors for transient hypoparathyroidism and hypocalcemia include preoperative low serum iPTH and calcium levels.
全甲状腺切除术后甲状旁腺功能减退症的发生率和危险因素是众所周知的。然而，半甲状腺切除术后甲状旁腺功能减退症和低钙血症的特征尚未得到很好的研究。在这项研究中，我们旨在评估半甲状腺切除术后甲状旁腺功能减退症和低钙血症的发生率、特征和危险因素。
我们回顾性分析了 2012 年 1 月至 2019 年 4 月期间接受半甲状腺切除术（伴或不伴中央颈部清扫术）的 321 例患者的医疗数据。我们连续分析了血清全甲状旁腺激素（iPTH）、钙和离子钙（iCa）水平（术前和术后手术当天；第 1 天和第 3 天；第 1、3、6 和 12 个月），并评估了术后甲状旁腺功能减退症和低钙血症的危险因素。
半甲状腺切除术后手术当天及术后第 1 天和第 3 天，iPTH 和钙水平明显下降，术后 1 个月恢复术前水平。iCa 水平在手术当天和术后第 1 天明显下降。16 例（5%）患者发生暂时性甲状旁腺功能减退症和 250 例（78%）患者发生暂时性低钙血症，术后 1 个月恢复正常。8 例（2.5%）患者出现轻度低钙血症症状，需要口服补钙。未观察到永久性甲状旁腺功能减退症或低钙血症。术前血清 iPTH 和钙水平较低与半甲状腺切除术后暂时性甲状旁腺功能减退症和低钙血症有关。
约 5%和 2.5%的患者在半甲状腺切除术后出现暂时性甲状旁腺功能减退症和轻度症状性低钙血症。暂时性甲状旁腺功能减退症和低钙血症的危险因素包括术前血清 iPTH 和钙水平较低。
