Al-Hakami Hadi Afandi, Alsolamy Renad M, I Awad Baraa, Mandora Roaa M, Hamdan Dalia, Alzahrani Rakan, Alaqsam Yousef, Al-Garni Mohammed
College of Medicine, Department of Otolaryngology-Head & Neck Surgery, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center/Ministry of the National Guard - Health Affairs, Jeddah, SAU.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Jeddah, SAU.
Cureus. 2024 Mar 20;16(3):e56585. doi: 10.7759/cureus.56585. eCollection 2024 Mar.
Thyroidectomy technique and extent are related to parathyroid injury and hypoparathyroidism. Total thyroidectomy is one of the most commonly performed endocrine surgeries, and the majority of patients recover completely without any complications. However, persistent hypoparathyroidism is the most prevalent long-term consequence following total thyroidectomy. While it is seldom deadly, it can cause severe morbidity for the patient and raise healthcare expenses.
This retrospective cohort study was conducted at King Abdulaziz Medical City, Jeddah, Saudi Arabia. We included all confirmed thyroid cancer cases that underwent thyroidectomy with or without neck dissection between July 2016 and August 2022. The data was collected from a chart review of the electronic medical record system (BEST-care), and a data collection sheet was utilized. SPSS version 26 was used to analyze the data.
A total of 192 patients undergoing thyroid surgery were enrolled. One hundred forty-three (74.5%) were females and the mean age of participants was 45.29 ± 16.88 years. Most patients, 170 (88.5%), had a papillary histological type, and total thyroidectomy was performed in 150 (78.1%). A significant association was found between the type of surgery and postoperative hypoparathyroidism (p=<0.05*). In addition, hypocalcemia was seen in 147 (76.6%) of the patients. Postoperative hypoparathyroidism was significantly higher among patients who had asymptomatic postoperative hypocalcemia and those who received IV calcium gluconate (p=<0.05*). Moreover, postoperative hypocalcemia, hypomagnesemia, and hyperphosphatemia were significantly associated with postoperative hypoparathyroidism (p=<0.05*).
The incidence of postoperative hypoparathyroidism is significantly higher among patients who underwent total thyroidectomy and had a normal level of preoperative parathyroid hormone (PTH) and magnesium (Mg) levels. Identifying these factors is a crucial step to minimize the occurrence of such complications.
甲状腺切除术的技术和范围与甲状旁腺损伤及甲状旁腺功能减退有关。全甲状腺切除术是最常施行的内分泌手术之一，大多数患者可完全康复且无任何并发症。然而，持续性甲状旁腺功能减退是全甲状腺切除术后最常见的长期后果。虽然它很少致命，但会给患者带来严重的发病风险并增加医疗费用。
这项回顾性队列研究在沙特阿拉伯吉达的阿卜杜勒阿齐兹国王医疗城进行。我们纳入了2016年7月至2022年8月期间所有确诊的甲状腺癌病例，这些病例接受了甲状腺切除术，无论是否进行了颈部清扫。数据通过对电子病历系统（BEST-care）的病历审查收集，并使用了数据收集表。使用SPSS 26版软件进行数据分析。
共有192例接受甲状腺手术的患者入组。其中143例（74.5%）为女性，参与者的平均年龄为45.29±16.88岁。大多数患者，即170例（88.5%），组织学类型为乳头状，150例（78.1%）进行了全甲状腺切除术。手术类型与术后甲状旁腺功能减退之间存在显著关联（p<0.05*）。此外，147例（76.6%）患者出现低钙血症。术后无症状性低钙血症患者和接受静脉注射葡萄糖酸钙的患者术后甲状旁腺功能减退显著更高（p<0.05*）。此外，术后低钙血症、低镁血症和高磷血症与术后甲状旁腺功能减退显著相关（p<0.05*）。
术前甲状旁腺激素（PTH）和镁（Mg）水平正常的患者，在接受全甲状腺切除术后，术后甲状旁腺功能减退的发生率显著更高。识别这些因素是将此类并发症的发生降至最低的关键步骤。
