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KMID : 0986520160160030070
Korean Journal of Endoscrine Surgery
2016 Volume.16 No. 3 p.70 ~ p.78
Risk Factors of Postoperative Hypocalcemia after Total Thyroidectomy of Papillary Thyroid Carcinoma Patients
Seong Ji-Young

Lee Cho-Rok
Kim Min-Jhi
Kim Tae-Hyung
Lee Seul-Gi
Choi Jung-Bum
Ban Eun-Jeong
Kang Sang-Wook
Lee Jan-Dee
Jeong Jong-Ju
Nam Kee-Hyun
Chung Woong-Youn
Park Cheong-Soo
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
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