Zhongguo quanke yixue (Aug 2022)

Influencing Factors of Hypoparathyroidism in Patients with Differentiated Thyroid Carcinoma after Radical Thyroidectomy

  • Shunli LU, Jianping YU, Hongtao LI, Weikai CHEN, Andong LI, Chao CHEN, Qingyuan HE, Xiaopeng HAN

DOI
https://doi.org/10.12114/j.issn.1007-9572.2022.0210
Journal volume & issue
Vol. 25, no. 23
pp. 2869 – 2873

Abstract

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Background Hypoparathyroidism is one of the common complications of radical thyroidectomy, but there are few studies on differentiated thyroid cancer. Objective To investigate the influencing factors of hypoparathyroidism in patients with differentiated thyroid carcinoma after radical thyroidectomy. Methods A total of 166 patients with differentiated thyroid carcinoma who underwent radical thyroidectomy from 940 Hospital of PLA Joint Logistics Support Force from June 2018 to December 2020 were included, and their clinical data were collected, including gender, age, body mass index (BMI), tumor site, tumor size, blood supply of lesion, whether there is capsule invasion, surgical method, scope of lymph node dissection, whether there is use of carbon nanoparticles, parathyroid gland resection. Also, this study monitors preoperative and postoperative serum PTH and follow-up monitoring levels of Ca2+. Results Among the 166 patients, the incidence of postoperative hypoparathyroidism was 28.31% (47/166), among which the incidence of temporary hypoparathyroidism was 21.68% (36/166) and the incidence of permanent hypoparathyroidism was 6.63% (11/166). There were statistically significant differences between patients with normal parathyroid function and patients with hypoparathyroidism in gender, age, tumor location, membranous invasion, surgical method, lymph node dissection and the use of carbon nanotube (P<0.05). The results of multivariate Logistic regression analysis showed that advanced age〔OR=1.042, 95%CI (1.003, 1.083) 〕, membranous invasion〔OR=2.825, 95%CI (1.198, 6.659) 〕 were risk factors for hypoparathyroidism in patients with differentiated thyroid carcinoma after radical thyroidectomy (P<0.05), Da Vinci robotic surgery〔OR=0.278, 95%CI (0.089, 0.868) 〕 and use of carbon nanoscale〔OR=0.374, 95%CI (0.144, 0.970) 〕 were protective factors for hypoparathyroidism in patients with differentiated thyroid carcinoma after radical thyroidectomy (P<0.05) . Conclusion Aging and capsular invasion are risk factors for hypoparathyroidism in patients with differentiated thyroid carcinoma after radical thyroidectomy. Da Vinci robotic surgery and the use of carbon nanoparticles can help reduce the risk of postoperative hypoparathyroidism.

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