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  11. Risk Factors Of Transient And Permanent Hypoparathyroidism After Thyroidectomy: A Systematic Review And Meta-analysis

Risk factors of transient and permanent hypoparathyroidism after thyroidectomy: a systematic review and meta-analysis

Kang Ning1,2, Yongchao Yu1,2, Xinyi Zheng3

  • 1Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center.

International Journal of Surgery (London, England)
|April 23, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Postoperative hypoparathyroidism (hypoPT) risk factors after thyroid surgery were identified. Female sex, cancer pathology, and neck dissection significantly increase hypoPT risk, emphasizing surgical approach and intraoperative care for prevention.

Area of Science:

  • Endocrinology and Surgical Oncology

Background:

  • Postoperative hypoparathyroidism (hypoPT) is a frequent complication after thyroid surgery.
  • Existing research on hypoPT risk factors is inconsistent, necessitating a comprehensive analysis of transient and permanent hypoPT.
  • Understanding these factors is crucial for improving patient outcomes.

Purpose of the Study:

  • To systematically review and meta-analyze risk factors associated with transient and permanent hypoPT following thyroid surgery.
  • To identify key demographic, surgical, and pathological factors influencing hypoPT development.

Main Methods:

  • A systematic literature search was conducted on PubMed and Embase databases up to 2024.
  • Ninety-three studies were included, with study quality assessed using the Newcastle-Ottawa Scale.
  • Pooled odds ratios were calculated to determine the association between risk factors and hypoPT, with subgroup analyses and publication bias assessments performed.

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Main Results:

  • Nineteen risk factors were analyzed, with sex and parathyroid autotransplantation being most common.
  • Female sex, advanced cancer staging (cN stage), central and lateral neck dissections, total thyroidectomy, and cancer pathology were significantly associated with both transient and permanent hypoPT.
  • Preoperative calcium and parathyroid autotransplantation were linked to transient hypoPT, while preoperative PTH acted as a protective factor. Node metastasis and parathyroid presence in the specimen correlated with permanent hypoPT.

Conclusions:

  • Female thyroid cancer patients undergoing total thyroidectomy with neck dissection and lymph node metastasis face the highest risk of hypoPT.
  • Optimizing surgical strategy and intraoperative protection are paramount for preventing postoperative hypoPT.