Keywords
post-surgical hypocalcemia
neck surgery
How to Cite
Abstract
Background: The most frequent complication of neck surgery in thyroid cancer is postoperative hypoparathyroidism. Its prevalence depends on many variables and the repercussions on the quality of life of patients are significant. To date, the prevalence of postoperative hypoparathyroidism in thyroid cancer surgery in the Colombian population is unknown, interfering with early prevention and management strategies in our country. We present a study that shows the prevalence of transient and permanent hypocalcemia due to post-thyroidectomy hypoparathyroidism in a 4th level institution, using a protocol of calcium and calcitriol supplementation in the immediate postoperative period of surgery as a basis to create prevention strategies and early management in our patients.
Methods: A cross-sectional, observational retrospective study was conducted with information obtained from clinical records of patients undergoing thyroidectomy for thyroid cancer between 2003 and 2017 at the “Hospital Universitario Santa Fé de Bogotá”. Data were collected through the head and neck surgery database registry. The groups were divided to assess the prevalence of transient and permanent hypocalcemia.
Results: Data from 261 patients were analyzed, finding a median age of 48.6 years. The univariate analysis showed a higher prevalence of the disease in women (75%) and the diagnosis of papillary thyroid carcinoma (85%) was the most related to surgical intervention. The prevalence of post-surgical hypocalcemia at 3 months POP was 18%, compared to 7% at 7 months.
Conclusions: The prevalence of post-thyroidectomy hypoparathyroidism for the management of thyroid cancer in a 4th level institution of complexity in Bogotá, in the hands of a high volume expert surgeon is close to 20% with reduction to 8% at 7 months, with rates less than those reported but significant, which demonstrates the importance of creating strategies for prevention and early management. There is a need for registers at a national level to analyze the behavior of patients undergoing surgery in the central compartment of the neck, in order to establish supplementation protocols that prevent the morbidity rate of patients with permanent sequelae.
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