Thoughts and suggestions on the definition of hypoparathyroidism after thyroidectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DONG Zhizhong ,  CHENG Ruochuan

Center for Diagnosis and Treatment of Thyroid Disease, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, P. R. China;

Corresponding?author：

CHENG Ruochuan, Email: cruochuan@foxmail.com

Keywords：

hypothyroidism; definition; thyroidectomy

DOI：

10.7507/1007-9424.202410030

Video：

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Hypothyroidism is one of the focuses of attention in the field of thyroid surgery, but postoperative hypoparathyroidism has always been an unavoidable complication for surgeons. Currently, there is still controversy over the definition and classification of postoperative hypoparathyroidism, and there are significant differences in the definition and incidence of permanent hypoparathyroidism among different studies. The author provides preliminary suggestions and ideas for the diagnosis and definition of hypoparathyroidism based on relevant guidelines, literature, and clinical experience, in order to provide more accurate diagnosis and treatment plans for postoperative hypoparathyroidism.

Citation： DONG Zhizhong, CHENG Ruochuan. Thoughts and suggestions on the definition of hypoparathyroidism after thyroidectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(11): 1281-1285. doi: 10.7507/1007-9424.202410030 Copy

1.	葛明華, 高明, 程若川. 中國腫瘤整合診治指南. 甲狀腺癌. 天津: 天津科學技術出版社, 2022: 1-138.
2.	Orloff LA, Wiseman SM, Bernet VJ, et al. American Thyroid Association Statement on Postoperative Hypoparathyroidism: Diagnosis, Prevention, and Management in Adults. Thyroid, 2018, 28(7): 830-841.
3.	Bollerslev J, Rejnmark L, Marcocci C, et al. European Society of Endocrinology Clinical Guideline: treatment of chronic hypoparathyroidism in adults. Eur J Endocrinol, 2015, 173(2): G1-G20.
4.	Ning K, Yu Y, Zheng X, et al. Risk factors of transient and permanent hypoparathyroidism after thyroidectomy: a systematic review and meta-analysis. Int J Surg, 2024, 110(8): 5047-5062.
5.	Shoback DM, Bilezikian JP, Costa AG, et al. Presentation of hypoparathyroidism: etiologies and clinical features. J Clin Endocrinol Metab, 2016, 101(6): 2300-2312.
6.	Cusano NE, Bilezikian JP. Signs and symptoms of hypoparathyroidism. Endocrinol Metab Clin North Am, 2018, 47(4): 759-770.
7.	Cooper MS, Gittoes NJ. Diagnosis and management of hypocalcaemia. BMJ, 2008, 336(7656): 1298-1302.
8.	董治中, 劉文, 蘇艷軍, 等. 甲狀腺全部切除術后甲狀旁腺功能不全7例臨床病例分析報告. 中國普外基礎與臨床雜志, 2022, 29(10): 1334-1338.
9.	Promberger R, Ott J, Kober F, et al. Normal parathyroid hormone levels do not exclude permanent hypoparathyroidism after thyroidectomy. Thyroid, 2011, 21(2): 145-150.
10.	Al-Khatib T, Althubaiti AM, Althubaiti A, et al. Severe vitamin D deficiency: a significant predictor of early hypocalcemia after total thyroidectomy. Otolaryngol Head Neck Surg, 2015, 152(3): 424-431.
11.	Bilezikian JP, Brandi ML, Cusano NE, et al. Management of hypoparathyroidism: present and future. J Clin Endocrinol Metab, 2016, 101(6): 2313-2324.
12.	Allgrove J, Adami S, Fraher L, et al. Hypomagnesaemia: studies of parathyroid hormone secretion and function. Clin Endocrinol (Oxf), 1984, 21(4): 435-449.
13.	Garrahy A, Murphy MS, Sheahan P. Impact of postoperative magnesium levels on early hypocalcemia and permanent hypoparathyroidism after thyroidectomy. Head Neck, 2016, 38(4): 613-619.
14.	中華醫學會骨質疏松和骨礦鹽疾病分會, 中華醫學會內分泌分會代謝性骨病學組. 甲狀旁腺功能減退癥臨床診療指南. 中華骨質疏松和骨礦鹽疾病雜志, 2018, 11(4): 323-337.
15.	Brandi ML, Bilezikian JP, Shoback D, et al. Management of hypoparathyroidism: summary statement and guidelines. J Clin Endocrinol Metab, 2016, 101(6): 2273-2283.
16.	Khan AA, Bilezikian JP, Brandi ML, et al. Evaluation and management of hypoparathyroidism summary statement and guidelines from the Second International Workshop. J Bone Miner Res, 2022, 37(12): 2568-2585.
17.	Misiorowski W, Dedecjus M, Konstantynowicz J, et al. Management of hypoparathyroidism: a Position Statement of the Expert Group of the Polish Society of Endocrinology. Endokrynol Pol, 2023, 74(5): 447-467.
18.	Villarroya-Marquina I, Sancho J, Lorente-Poch L, et al. Time to parathyroid function recovery in patients with protracted hypoparathyroidism after total thyroidectomy. Eur J Endocrinol, 2018, 178(1): 103-111.
19.	Ritter K, Elfenbein D, Schneider DF, et al. Hypoparathyroidism after total thyroidectomy: incidence and resolution. J Surg Res, 2015, 197(2): 348-353.
20.	Kim SM, Kim HK, Kim KJ, et al. Recovery from permanent hypoparathyroidism after total thyroidectomy. Thyroid, 2015, 25(7): 830-833.
21.	郝軍生. 甲狀腺全切術后甲狀旁腺功能減退的恢復時間分析 (附13例). 現代腫瘤醫學, 2020, 28(11): 1867-1869.
22.	張萌萌. 生命、骨骼、維生素D3. 中國骨質疏松雜志, 2016, 22(11): 1496-1500.
23.	Holick MF. Vitamin D deficiency. N Engl J Med, 2007, 357(3): 266-281.
24.	Unsal IO, Calapkulu M, Sencar ME, et al. Preoperative vitamin D levels as a predictor of transient hypocalcemia and hypoparathyroidism after parathyroidectomy. Sci Rep, 2020, 10(1): 9895. doi: 10.1038/s41598-020-66889-8.
25.	Casey C, Hopkins D. The role of preoperative vitamin D and calcium in preventing post-thyroidectomy hypocalcaemia: a systematic review. Eur Arch Otorhinolaryngol, 2023, 280(4): 1555-1563.
26.	中國醫師協會外科醫師分會甲狀腺外科醫師委員會. 甲狀腺手術中甲狀旁腺保護專家共識. 中國實用外科雜志, 2015, 35(7): 731-736.
27.	陳會彬. 甲狀腺全切術后預防性補鈣的臨床研究. 昆明: 昆明醫學院, 2011.
28.	艾楊卿. 甲狀腺術中甲狀旁腺的功能保護及術后預防性補鈣對患者影響的臨床研究. 昆明: 昆明醫學院, 2009.
29.	程若川, 劉文. 中國甲狀腺癌術后隨訪和臨床研究現狀反思. 中國普通外科雜志, 2017, 26(11): 1375-1382.
30.	程若川, 劉文. 厚積薄發—中國甲狀腺腫瘤臨床數據庫分級質量管理的建議與思考. 中國普通外科雜志, 2020, 29(11): 1285-1292.
31.	Harsl?f T, Rolighed L, Rejnmark L. Huge variations in definition and reported incidence of postsurgical hypoparathyroidism: a systematic review. Endocrine, 2019, 64(1): 176-183.

1. 葛明華, 高明, 程若川. 中國腫瘤整合診治指南. 甲狀腺癌. 天津: 天津科學技術出版社, 2022: 1-138.
2. Orloff LA, Wiseman SM, Bernet VJ, et al. American Thyroid Association Statement on Postoperative Hypoparathyroidism: Diagnosis, Prevention, and Management in Adults. Thyroid, 2018, 28(7): 830-841.
3. Bollerslev J, Rejnmark L, Marcocci C, et al. European Society of Endocrinology Clinical Guideline: treatment of chronic hypoparathyroidism in adults. Eur J Endocrinol, 2015, 173(2): G1-G20.
4. Ning K, Yu Y, Zheng X, et al. Risk factors of transient and permanent hypoparathyroidism after thyroidectomy: a systematic review and meta-analysis. Int J Surg, 2024, 110(8): 5047-5062.
5. Shoback DM, Bilezikian JP, Costa AG, et al. Presentation of hypoparathyroidism: etiologies and clinical features. J Clin Endocrinol Metab, 2016, 101(6): 2300-2312.
6. Cusano NE, Bilezikian JP. Signs and symptoms of hypoparathyroidism. Endocrinol Metab Clin North Am, 2018, 47(4): 759-770.
7. Cooper MS, Gittoes NJ. Diagnosis and management of hypocalcaemia. BMJ, 2008, 336(7656): 1298-1302.
8. 董治中, 劉文, 蘇艷軍, 等. 甲狀腺全部切除術后甲狀旁腺功能不全7例臨床病例分析報告. 中國普外基礎與臨床雜志, 2022, 29(10): 1334-1338.
9. Promberger R, Ott J, Kober F, et al. Normal parathyroid hormone levels do not exclude permanent hypoparathyroidism after thyroidectomy. Thyroid, 2011, 21(2): 145-150.
10. Al-Khatib T, Althubaiti AM, Althubaiti A, et al. Severe vitamin D deficiency: a significant predictor of early hypocalcemia after total thyroidectomy. Otolaryngol Head Neck Surg, 2015, 152(3): 424-431.
11. Bilezikian JP, Brandi ML, Cusano NE, et al. Management of hypoparathyroidism: present and future. J Clin Endocrinol Metab, 2016, 101(6): 2313-2324.
12. Allgrove J, Adami S, Fraher L, et al. Hypomagnesaemia: studies of parathyroid hormone secretion and function. Clin Endocrinol (Oxf), 1984, 21(4): 435-449.
13. Garrahy A, Murphy MS, Sheahan P. Impact of postoperative magnesium levels on early hypocalcemia and permanent hypoparathyroidism after thyroidectomy. Head Neck, 2016, 38(4): 613-619.
14. 中華醫學會骨質疏松和骨礦鹽疾病分會, 中華醫學會內分泌分會代謝性骨病學組. 甲狀旁腺功能減退癥臨床診療指南. 中華骨質疏松和骨礦鹽疾病雜志, 2018, 11(4): 323-337.
15. Brandi ML, Bilezikian JP, Shoback D, et al. Management of hypoparathyroidism: summary statement and guidelines. J Clin Endocrinol Metab, 2016, 101(6): 2273-2283.
16. Khan AA, Bilezikian JP, Brandi ML, et al. Evaluation and management of hypoparathyroidism summary statement and guidelines from the Second International Workshop. J Bone Miner Res, 2022, 37(12): 2568-2585.
17. Misiorowski W, Dedecjus M, Konstantynowicz J, et al. Management of hypoparathyroidism: a Position Statement of the Expert Group of the Polish Society of Endocrinology. Endokrynol Pol, 2023, 74(5): 447-467.
18. Villarroya-Marquina I, Sancho J, Lorente-Poch L, et al. Time to parathyroid function recovery in patients with protracted hypoparathyroidism after total thyroidectomy. Eur J Endocrinol, 2018, 178(1): 103-111.
19. Ritter K, Elfenbein D, Schneider DF, et al. Hypoparathyroidism after total thyroidectomy: incidence and resolution. J Surg Res, 2015, 197(2): 348-353.
20. Kim SM, Kim HK, Kim KJ, et al. Recovery from permanent hypoparathyroidism after total thyroidectomy. Thyroid, 2015, 25(7): 830-833.
21. 郝軍生. 甲狀腺全切術后甲狀旁腺功能減退的恢復時間分析 (附13例). 現代腫瘤醫學, 2020, 28(11): 1867-1869.
22. 張萌萌. 生命、骨骼、維生素D3. 中國骨質疏松雜志, 2016, 22(11): 1496-1500.
23. Holick MF. Vitamin D deficiency. N Engl J Med, 2007, 357(3): 266-281.
24. Unsal IO, Calapkulu M, Sencar ME, et al. Preoperative vitamin D levels as a predictor of transient hypocalcemia and hypoparathyroidism after parathyroidectomy. Sci Rep, 2020, 10(1): 9895. doi: 10.1038/s41598-020-66889-8.
25. Casey C, Hopkins D. The role of preoperative vitamin D and calcium in preventing post-thyroidectomy hypocalcaemia: a systematic review. Eur Arch Otorhinolaryngol, 2023, 280(4): 1555-1563.
26. 中國醫師協會外科醫師分會甲狀腺外科醫師委員會. 甲狀腺手術中甲狀旁腺保護專家共識. 中國實用外科雜志, 2015, 35(7): 731-736.
27. 陳會彬. 甲狀腺全切術后預防性補鈣的臨床研究. 昆明: 昆明醫學院, 2011.
28. 艾楊卿. 甲狀腺術中甲狀旁腺的功能保護及術后預防性補鈣對患者影響的臨床研究. 昆明: 昆明醫學院, 2009.
29. 程若川, 劉文. 中國甲狀腺癌術后隨訪和臨床研究現狀反思. 中國普通外科雜志, 2017, 26(11): 1375-1382.
30. 程若川, 劉文. 厚積薄發—中國甲狀腺腫瘤臨床數據庫分級質量管理的建議與思考. 中國普通外科雜志, 2020, 29(11): 1285-1292.
31. Harsl?f T, Rolighed L, Rejnmark L. Huge variations in definition and reported incidence of postsurgical hypoparathyroidism: a systematic review. Endocrine, 2019, 64(1): 176-183.

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