Permanent hypoparathyroidism following total thyroidectomy – Incidence and preventative strategies without imaging adjuncts - 12/04/25
, Alexander Papachristos a, b, Hazel Serrao-Brown a, Adam Aniss a, Mark Sywak a, b, Stan Sidhu a, bAbstract |
Introduction |
Permanent hypoparathyroidism (pHypoPT) is the most common permanent complication of total thyroidectomy. We aim to describe the incidence and predictors of hypoparathyroidism in a consecutive series of patients treated in a high-volume centre and define strategies to reduce the risk of pHypoPT.
Methods |
1182 patients who underwent total thyroidectomy between April 2018 and June 2022 were analyzed. Temporary hypoparathyroidism (tHypoPT) was defined as PTH <0.4 pmol/L (<4 pg/mL) at day one post-operatively, or clinical or biochemical evidence of hypocalcemia. pHypoPT was defined as an ongoing need for calcitriol supplementation to maintain normocalcemia at 12 months. Symptomatic tHypoPT (OR 43.97, p < 0.001) and number of parathyroid glands in the operative specimen (OR 2.31, p = 0.022) were also significantly associated with pHypoPT.
Results |
Biochemical tHypoPT occurred in 205 (17.4 %) patients whilst pHypoPT occurred in 6 (0.5 %) patients. On multivariate analysis, parathyroid auto-transplantation (PA) independently reduced the risk of pHypoPT (OR 0.04, p = 0.004).
Conclusions |
The risk of pHypoPT after total thyroidectomy is 0.5 % when performed by high-volume surgeons. PA represents an important technique that reduces the risk of pHypoPT.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | pHypoPT risk after total thyroidectomy performed by high-volume surgeons is <1 %. |
• | Among patients with pHypoPT, one third had recovery of PTH levels, but an ongoing calcitriol supplementation requirement. |
• | On multivariate analysis, parathyroid auto-transplant independently reduced the risk of pHypoPT. |
Keywords : Permanent hypoparathyroidism, Total thyroidectomy, Parathyroid auto-transplantation
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Vol 243
Articolo 116196- maggio 2025 Ritorno al numero
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