Korean J Endocr Surg.  2016 Sep;16(3):70-78. 10.16956/kaes.2016.16.3.70.

Risk Factors of Postoperative Hypocalcemia after Total Thyroidectomy of Papillary Thyroid Carcinoma Patients

• Seong JY
• Lee CR
• Kim MJ
• Kim TH
• Lee SG
• Choi JB
• Ban EJ
• Kang SW
• Lee J
• Jeong JJ
• Nam KH
• Chung WY
• Park CS

• KMID: 2357839
• DOI: http://doi.org/10.16956/kaes.2016.16.3.70

Abstract

PURPOSE
Postoperative hypocalcemia is a common complication of thyroidectomy. This study evaluated the incidence and predisposing risk factors for postoperative permanent hypocalcemia after total thyroidectomy.
METHODS
There were 1,247 consecutive patients undergoing total thyroidectomy and complete treatment and observation for differentiated thyroid cancer between January 2012 to December 2012 who were enrolled in this study. Patients were divided into two groups, those remaining normalcalcemic (Group I-824 pts) and those who had hypocalcemia requiring treatment (Groups II-423 pts). Group II was subdivided into a transient hypocalcemic group (Group IIA-409 pts) and a permanent hypocalcemic group (Group IIB-14 pts).
RESULTS
Female gender, thyroiditis, preserved parathyroid number, lateral lymph node metastasis, RAI treatment, preoperative parathyroid hormone and preoperative vitamin D were significantly associated with the development of postoperative hypocalcemia by multivariate analysis. Comparing patients with transient versus permanent hypocalcemia, tumor size and multiplicity were significantly related to the development of permanent hypocalcemia by multivariate analysis. RAI treatment and parathyroid hormone level on the postoperative third day were significantly related to recovery from transient hypocalcemia to normo-calcemia.
CONCLUSION
Risk factors of postoperative hypocalcemia were associated with preoperative patient factors and advanced thyroid cancer. Advanced thyroid cancer was a risk factor for permanent hypocalcemia. To prevent postoperative hypocalcemia, we should focus on patient condition and need to preserve parathyroid gland more carefully in thyroid surgery.

Keyword

Hypocalcemia; Risk factors; Total thyroidectomy; Papillary thyroid cancer

MeSH Terms

Female
Humans
Hypocalcemia*
Incidence
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Parathyroid Glands
Parathyroid Hormone
Risk Factors*
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy*
Thyroiditis
Vitamin D
Parathyroid Hormone
Vitamin D

Figure

• 

  Fig. 1 Time to resolution of transient hypocalcemia.

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