Medicine
Ali Sharifi; Fariborz Rousta
Abstract
Introduction: Post-thyroidectomy hypocalcemia is a significant complication that can occur following thyroid surgery. Patient-related factors, surgical factors, and pathological factors contribute to the development of hypocalcemia. Prompt recognition, appropriate management, and preventive measures ...
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Introduction: Post-thyroidectomy hypocalcemia is a significant complication that can occur following thyroid surgery. Patient-related factors, surgical factors, and pathological factors contribute to the development of hypocalcemia. Prompt recognition, appropriate management, and preventive measures are essential to minimize the occurrence of hypocalcemia and its associated complications.Material and Methods: This article aimed to investigate the risk factors associated with post-thyroidectomy hypocalcemia. A retrospective cohort study design was employed to analyze data from patients who underwent thyroidectomy at a single institution. The study period spanned from January 2018 to December 2020. The study protocol was approved by the Institutional Review Board (IRB) of the institution.Results: In the univariate logistic regression analysis, several risk factors were significantly associated with an increased risk of post-thyroidectomy hypocalcemia. Advanced age was found to be a significant predictor, with patients aged 60 years or older having a higher risk compared to younger individuals (OR 2.4, 95% CI 1.5-3.8, p<0.001). Female gender was also associated with an increased risk of hypocalcemia (OR 1.8, 95% CI 1.2-2.7, p=0.005)Conclusion: this study identified several risk factors associated with post-thyroidectomy hypocalcemia, including advanced age, female gender, lower preoperative calcium levels, total thyroidectomy, presence of thyroid cancer, and extensive thyroid gland involvement. These findings can aid in preoperative risk stratification, surgical planning, and patient counseling.
Medicine
Abdolreza Mehdinavaz Aghdam; Fariborz Rousta
Abstract
Introduction: Another rare surgical cause of voice change after thyroidectomy is cervical muscle injury Causes of failure may include pulmonary edema, edema, or airway obstruction. The aim of this study was to determine the frequency of unplanned parathyroidectomy, unplanned parathyroidectomy, postoperative ...
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Introduction: Another rare surgical cause of voice change after thyroidectomy is cervical muscle injury Causes of failure may include pulmonary edema, edema, or airway obstruction. The aim of this study was to determine the frequency of unplanned parathyroidectomy, unplanned parathyroidectomy, postoperative hypocalcemia and the risk of unplanned parathyroidectomy in patients undergoing thyroid surgery in our clinic. Material and Methods: Comparison of postoperative Ca value with age, gender, preoperative Ca value, dominant nodule diameter on ultrasonography (USG), type of surgery (total/lobectomy), and histopathological findings of thyroidectomy material (malignant/benign, with or without incident parathyroidectomy) is closed. Blood calcium levels below 8 mg/dL, measured after the first 24 hours after surgery, are indicative of postoperative hypocalcemia. Results: There was no relationship between nodule diameter and hypocalcemia. When patients were divided into malignant and benign groups, there was no significant difference between these groups in terms of performance after hypocalcemia. When patients were divided into groups with and without incident parathyroidectomy, there was no significant difference in postoperative hypocalcemia between these groups. Conclusion: In our study, female gender, age <28.5 years, low preoperative Ca value and total thyroidectomy were considered to be associated with hypocalcemia. Although there is no association between parathyroidectomy and postoperative hypocalcemia, this problem can be avoided by careful removal and imaging of the thyroid gland, especially in patients including patients with malignant thyroidectomy and total thyroidectomy.
Covid
Abdolreza Mehdinavaz Aghdam; Fariborz Rousta
Abstract
Introduction: The aim of this study was to determine the outcome of low PTH after surgery and to monitor parathyroid recovery times in patients who underwent total thyroidectomy. Material and Methods: A commercially available PTH (iPTH) test was used to monitor iPTH levels on days 1 and 4. PTH levels ...
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Introduction: The aim of this study was to determine the outcome of low PTH after surgery and to monitor parathyroid recovery times in patients who underwent total thyroidectomy. Material and Methods: A commercially available PTH (iPTH) test was used to monitor iPTH levels on days 1 and 4. PTH levels were negative. It is determined by the same blood test as the sCa level. To exclude vitamin D deficiency, we first measured 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels in all patients Postoperative hypoparathyroidism was defined as postoperative albumin-adjusted sCa levels below 1.9 mmol/L (Convert to mg/dL, divide) with 0.25 (range of use, 2.10-2.60 mmol/L) symptoms of hypocalcemia (response to neuromuscular stress including paresthesias, muscle spasms, tetany or seizures) or sCa levels lower than results (1.9-2.1 mmol/L) with neuromuscular symptoms during the first 4 days after surgery. Results: In a multivariate logistic regression model, we found that patients who received an autograft of parathyroid tissue during surgery were more likely to have low PTH immediately after surgery (OR = 2.6; 95% CI, 1.8-3.8). Additionally, patients with parathyroid tissue who showed negative parathyroid tissue removal on the final pathology report were more likely to have postoperative PTH <10 pg/mL (OR = 2.2; 95% CI, 1.5 -3.3). Parathyroid tissue was the only risk factor for permanent hypoparathyroidism in the pathology report (OR = 3.6, 95% CI, 1.1–11.5). Conclusion: This study suggests that drug therapy should be considered in addition to PTH measurement, as 50% of patients with persistent hypoparathyroidism have elevated PTH levels to ≥10 pg/mL, but still want more help to avoid hypoparathyroidism. Symptoms of calcemia. In addition, 12 months may be the most appropriate time to define persistent hypoparathyroidism, as 5% of patients with low PTH resolve 6-12 months after treatment.
