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Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
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Previous gastric bypass surgery complicating total thyroidectomy.

Bianca Alfonso1, Adam S Jacobson, Eran E Alon

  • 1Department of Endocrinology, South Miami Hospital, Miami, FL, USA.

Ear, Nose, & Throat Journal
|March 5, 2015
PubMed
Summary
This summary is machine-generated.

Patients with prior gastric bypass surgery face higher risks of hypocalcemia after total thyroidectomy. Aggressive calcium and vitamin D supplementation is crucial for managing this complication in bariatric surgery patients.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Hypocalcemia is a known complication following total thyroidectomy.
  • Patients with prior gastric bypass surgery may have increased risk due to malabsorption, secondary hyperparathyroidism, and vitamin D deficiency.

Observation:

  • A 58-year-old woman with a history of Roux-en-Y gastric bypass underwent total thyroidectomy for papillary thyroid carcinoma.
  • She developed severe postoperative hypocalcemia requiring substantial calcium and vitamin D supplementation.

Findings:

  • The patient required high doses of oral and intravenous calcium, along with calcitriol and ergocalciferol, to maintain normal serum calcium levels.
  • Despite persistent hypoparathyroidism, her calcium levels stabilized with this intensive regimen post-discharge.

Implications:

  • Bariatric surgery patients undergoing thyroid surgery necessitate aggressive calcium and vitamin D supplementation.
  • Preoperative supplementation is strongly recommended to mitigate the risk of severe hypocalcemia.