Document Detail


Postoperative hypocalcemia in patients who did or did not undergo parathyroid autotransplantation during thyroidectomy: a comparative study.
MedLine Citation:
PMID:  9854587     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Permanent hypoparathyroidism is a recognized complication of thyroidectomy. Apart from preservation of parathyroid glands in situ by meticulous dissection, parathyroid autotransplantation (PTHAT) has been performed increasingly to avoid permanent hypoparathyroidism. METHODS: From January 1995 to October 1997, PTHAT was performed routinely for devascularized or inadvertently removed glands in 98 (36%) of 271 patients undergoing thyroidectomy. Potential risk factors and the impact of PTHAT on postoperative hypocalcemia were studied. RESULTS: Postoperative hypocalcemia occurred in 40 patients (14.8%), whereas 5 patients (1.8%) had permanent hypocalcemia during a median follow-up of 9 months. The incidence of transient hypocalcemia (n = 35) was higher in patients who underwent PTHAT (21.4%) than in patients who did not undergo PTHAT (8.1%) (P < .01). Permanent hypocalcemia occurred only in patients who did not undergo PTHAT. None of the 21 patients who had postoperative hypocalemia after PTHAT had permanent hypoparathyroidism compared with 26% (5/19) of patients who did not undergo PTHAT (P = .018). When the resected thyroid gland was examined for parathyroid tissue, the incidence of positive identification was higher in patients who did not undergo PTHAT (13%) than in patients who did undergo PTHAT (4%) (P = .015). CONCLUSIONS: Patients with postoperative hypocalcemia after PTHAT have virtually no risk of having permanent hypoparathyroidism. A more careful examination of the resected thyroid tissue can help to identify inadvertently removed parathyroid glands for autotransplantation.
Authors:
C Y Lo; K Y Lam
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Surgery     Volume:  124     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-01-11     Completed Date:  1999-01-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1081-6; discussion 1086-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Female
Follow-Up Studies
Humans
Hypocalcemia / epidemiology,  etiology*
Male
Middle Aged
Parathyroid Glands / transplantation*
Risk Factors
Thyroidectomy / adverse effects*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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