INCIDENCE AND CLINICAL PREDICTORS OF HYPOPARATHYROIDISM AND HYPOCALCEMIA POST THYROIDECTOMY

AUTHORS:
A. Kolinioti (Athens, Greece) , C. Polyzoes (Athens, Greece) , N. Mamidas (Athens, Greece) , E. Kardalas (Athens, Greece) , S. Kapiris (Athens, Greece)
Background:
Transient hypoparathyroidism is the most common complication after total thyroidectomy. The aim of this study was to evaluate the incidence and potential risk factors for postoperative hypocalcemia after thyroid surgery.
Methods:
A retrospective cohort study was conducted including patients who underwent total thyroidectomy with or without central neck dissection for both benign and malignant thyroid disorders in a five-year period; 2019 to 2023. Surgical indications, hormonal status, definitive histology, and postoperative calcium and PTH levels were analyzed.
Results:
A total of 296 patients were enrolled in the study. All patients underwent a total thyroidectomy with intraoperative nerve monitoring. Postoperative temporary hypoparathyroidism was more frequently associated with female sex, central neck dissection, and the yield of lymph node dissection. No permanent hypoparathyroidism or hypocalcemia was observed. Incidental parathyroidectomy did not necessarily correlate with postoperative hypocalcemia, suggesting that the pathogenesis of this complication could be attributed to an impaired blood supply to parathyroid glands during thyroid surgery.
Conclusions:
Approximately 5% of participants showed transient hypoparathyroidism and mild symptomatic hypocalcemia. Clinical risk factors identified include female sex, central neck dissection and specimen size.