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BMC Surgery
Published in: BMC Surgery 1/2019

Open Access 01-04-2019 | Thyroid Disease | Research article

Postoperative hypocalcemia: analysis of factors influencing early hypocalcemia development following thyroid surgery

Authors: Paolo Del Rio, Matteo Rossini, Chiara Montana Montana, Lorenzo Viani, Giuseppe Pedrazzi, Tommaso Loderer, Federico Cozzani

Published in: BMC Surgery | Special Issue 1/2019

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Abstract

Background

Early Hypocalcemia is the most frequent complication after thyroid surgery. Several studies have tried to identify factors (patient caracteristics or surgical technique variations) affecting hypocalcemia following thyroid surgery. This studiy evaluates the role of several factors in postoperative hypocalcemia development.

Methods

A retrospective study conducted on 2108 patients that underwent thyroid surgery in a single center (1669 women and 439 men). Postoperative early hypocalcemia was defined as serum calcium levels lower than 8,0 mg/dl measured 24 h after surgery. Following factors were evaluated in the study: sex, age, glandular hyperfunction, preoperative diagnosis, preoperative serum calcium levels, preoperative serum PTH levels, type of surgery performed (total thyroidectomy vs. lobectomy); minimally invasive video assisted thyroidectomy (MIVAT); number of parathyroid preserved in situ, postoperative serum calcium levels, changes in perioperative calcium levels (difference between preoperative values ​​and postoperative calcium levels), presence of carcinoma in the surgical specimen, presence of thyroiditis based on histopatology reports.

Results

Among evaluated factors only gender and surgical procedure revealed to be significantly correlated to early hypocalcemia development. In fact female patients experienced postoperative hypocalcemia in 42% (701/1669) of cases, which was signicantly higher than the 21.4% (94/439) identified in men. We also noticed a greater hypocalcemia incidence in patient undergoing total thyroidectomy (38.8%) than in patient undergoing lobectomy group (13.8%). Early hypocalcemia development didn’t appear to be related to preoperative serum calcium levels but it showed a statistically significant correlation with perioperative serum calcium level drop.

Conclusion

This findings suggest that sex (female gender is a strong risk factor),surgical procedure and perioperative changes in serum calcium are the only factors (among all variables examined) that influence early hypocalcemia development.
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Metadata
Title
Postoperative hypocalcemia: analysis of factors influencing early hypocalcemia development following thyroid surgery
Authors
Paolo Del Rio
Matteo Rossini
Chiara Montana Montana
Lorenzo Viani
Giuseppe Pedrazzi
Tommaso Loderer
Federico Cozzani
Publication date
01-04-2019
Publisher
BioMed Central
Published in
BMC Surgery / Issue Special Issue 1/2019
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-019-0483-y

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