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Risk Factors of Hypoparathyroidism Following Total Thyroidectomy for Thyroid Cancer

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Abstract

Background

The risk factors responsible for hypoparathyroidism after total thyroidectomy have not been completely defined. The present study evaluated one surgeon’s personal experience of postoperative hypoparathyroidism after total thyroidectomy for thyroid cancer and predisposing risk factors of postoperative hypoparathyroidism.

Methods

We performed a retrospective analysis of 531 consecutive total thyroidectomy cases for thyroid cancer operated by single surgeon at the Center for Thyroid Cancer, National Cancer Center, Korea, from March 2003 to August 2006.

Results

Postoperative hypoparathyroidism occurred in 135 patients (25.4 %), 19 of whom (3.6 % of total patients) experienced permanent hypoparathyroidism. Parathyroid autotransplantation, bilateral central lymph node dissection, gross extrathyroidal extension, and the presence of parathyroid gland in the pathologic specimen were associated with postoperative hypoparathyroidism in multivariate analysis (p < 0.05, respectively). The presence of parathyroid gland in the pathologic specimen and the early period of surgeon’s practice were statistically significant risk factors for permanent hypoparathyroidism in multivariate analysis (p < 0.05, respectively).

Conclusions

Careful surgical technique for in situ preservation of parathyroid gland and autotransplantation of inadvertently removed parathyroid gland are important, especially in case of gross extrathyroidal extension. Adequate surgical experience is also an important factor. And routine bilateral central lymph node dissection should be done thoughtfully for its effect on postoperative hypoparathyroidism.

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Authors and Affiliations

  1. Department of Surgery, Seoul National University College of Medicine, 101 Daehangno, 28 Yongon-dong, Jongno-gu, Seoul, 110-744, Republic of Korea

    Se Hyun Paek & Yeo Kyu Youn

  2. Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Ilsanno 323, Goyang, Gyeonggi-do, 410-769, Republic of Korea

    Young Mi Lee, Sun Young Min & Seok Won Kim

  3. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 43-gil Olympic-ro, Songpa-gu, Seoul, 138-736, Republic of Korea

    Ki Wook Chung

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  1. Se Hyun Paek
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  2. Young Mi Lee
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  3. Sun Young Min
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  4. Seok Won Kim
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  5. Ki Wook Chung
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Correspondence to Ki Wook Chung.

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Paek, S.H., Lee, Y.M., Min, S.Y. et al. Risk Factors of Hypoparathyroidism Following Total Thyroidectomy for Thyroid Cancer. World J Surg 37, 94–101 (2013). https://doi.org/10.1007/s00268-012-1809-4

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  • DOI: https://doi.org/10.1007/s00268-012-1809-4

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