[Parathyroid risk in thyroid surgery. Reality and prevention. 502 bilateral thyroidectomies].
Prospective study of parathyroid risk in a bulk of 502 consecutive bilateral thyroidectomies. Early post-operative hypocalcemia has been documented in 8,8% of the patients, but persisted in only 1,6% one year later. Late parathyroid risk of total thyroidectomy is 3,3% but increases twofold if neck dissection is simultaneously performed. Methods of this study probably misdiagnose a number of mild hypoparathyroidism. Lack of early hyperphosphoremia seems to be an optimizing criteria for aftermath. In Grave's disease, early post-operative hypocalcemia is more common (6,9%) but often subsides (definitive risk: 0,4%). This acceptable morbidity is compared to the data of literature. To prevent post-operative hypoparathyroidism a painstaking dissection of parathyroid blood supply seems more promising and effective than routine autotransplantation of the glands.
D006111:Graves Disease / Q000601:surgery; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology; D007011:Hypoparathyroidism / Q000209:etiology* / Q000517:prevention & control; D010280:Parathyroid Glands / Q000098:blood supply / Q000293:injuries*; D010758:Phosphorus / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D013965:Thyroidectomy / Q000009:adverse effects*; D013997:Time Factors
D010758:Phosphorus
Le risque parathyroïdien en chirurgie thyroïdienne. Sa réalité et sa prévention. 502 exérèses bilatérales.