Velicescu Cristian, Bilha Stefana Catalina, Teleman Alexandra, Vitelariu Andrada, Teodoriu Laura, Florescu Alexandru, Novac Roxana
Surgery Department, "Sf. Spiridon" Emergency Hospital, Iasi, Romania.
"Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
Arch Clin Cases. 2024 Oct 9;11(3):93-97. doi: 10.22551/2024.44.1103.10296. eCollection 2024.
The most common cause of hypoparathyroidism (hypoPT) in adults is iatrogenic due to total thyroidectomy, while the ideal moment for considering it chronic is still under debate. Our study aims at reporting the prevalence of transient and permanent hypoPT following thyroid surgery in a tertiary surgical center, as well as serum Parathormone (PTH) variation up to 12 months after surgery stratified according to the type of thyroid disease.
519 patients who underwent total thyroidectomy in a tertiary surgical center from 2018 to 2023 were analyzed. Postoperative hypoPT was defined as low PTH (less than 15 pg/ml) and/or hypocalcemia (albumin-corrected levels less than 8.5 mg/dl) on day 1 after surgery. Patients were considered to have permanent hypoPT if they had not recovered completely within 1 year after total thyroidectomy. PTH levels were compared according to the underlying thyroid disease.
140 patients (26.97%) had postoperative hypoPT. Twenty-two patients (4.23%) were considered to have permanent hypoPT 12 months after surgery. Approximately half of the patients recovered between 3 months and 12 months after surgery. HypoPT thyroiditis patients had higher PTH levels 3 months after surgery compared to papillary/follicular cancer and multinodular goiter, respectively, and all recovered 1 year after surgery. Papillary/follicular carcinoma was associated with a 29.4% rate of transient and 8.5% rate of chronic hypoPT, respectively.
Most patients without incidental parathyroidectomy that still develop postoperative hypoPT will eventually recover; nevertheless, it can take up to 1 year for full resolution. Measuring serum PTH 3 months postoperative may be of interest.
成人甲状旁腺功能减退症（甲旁减）最常见的病因是甲状腺全切术后的医源性因素，而将其视为慢性疾病的理想时机仍存在争议。我们的研究旨在报告在一家三级外科中心甲状腺手术后短暂性和永久性甲旁减的患病率，以及根据甲状腺疾病类型分层的术后12个月内血清甲状旁腺激素（PTH）的变化情况。
分析了2018年至2023年在一家三级外科中心接受甲状腺全切术的519例患者。术后甲旁减定义为术后第1天PTH水平低（低于15 pg/ml）和/或低钙血症（白蛋白校正水平低于8.5 mg/dl）。如果患者在甲状腺全切术后1年内未完全恢复，则被认为患有永久性甲旁减。根据潜在的甲状腺疾病比较PTH水平。
140例患者（26.97%）术后发生甲旁减。22例患者（4.23%）在术后12个月被认为患有永久性甲旁减。约一半的患者在术后3个月至12个月之间恢复。与乳头状/滤泡状癌和结节性甲状腺肿相比，甲旁减性甲状腺炎患者术后3个月的PTH水平较高，且所有患者在术后1年均恢复。乳头状/滤泡状癌分别与29.4%的短暂性甲旁减发生率和8.5%的慢性甲旁减发生率相关。
大多数未行甲状旁腺切除术但仍发生术后甲旁减的患者最终会恢复；然而，完全恢复可能需要长达1年的时间。术后3个月测量血清PTH可能有意义。
