title: [Dysfunction of calcium metabolism following resection of the thyroid gland. An analysis of important risk factors].
abstract: OBJECTIVE
  Dysfunction of the parathyroid glands is a typical complication following thyroid surgery. Risk factors for the development of postoperative symptomatic hypocalcemia were retrospectively analyzed.
  
  
  METHODS
  308 consecutive thyroid resections (women n = 236, men n = 72, mean age 53 years) performed in 1996 and 1997 were evaluated. Main diagnosis was non-toxic nodular goiter (n = 234, 76 %), 28 patients (9 %) had thyroid carcinoma. The most common operation performed was bilateral functional thyroid resection (n = 116, 38 %), the proportion of thyroidectomies was 14 % (n = 44). The patients with postoperative symptomatic hypocalcemia were followed for a median of 32 months.
  
  
  RESULTS
  Clinical symptoms of hypocalcemia were observed in 18 patients (6 %) postoperatively. Three patients developed transient (n = 1) or permanent hypothyroidism (n = 2). In univariate analysis, the underlying thyroid disease, the method of operative therapy, removal, identification and autotransplantation of parathyroid glands, in multivariate analysis, thyroidectomy (relative risk 6.9) and removal of parathyroid glands (relative risk 23.9) were proved to be significant risk factors for the development of postoperative symptomatic hypocalcemia (p < 0.05).
  
  
  CONCLUSIONS
  Patients with thyroidectomy, operation for thyroid carcinoma and intraoperative removal of parathyroid glands should be closely followed for postoperative hypocalcemia. Exact surgical technique provided, permanent hypoparathyroidism is rare, particularly if several parathyroid glands were identified intraoperatively and autotransplanted, if necessary.
authors.affiliation: Chirurgische Klinik u. Poliklinik der Universität Erlangen-Nürnberg, Germany. thomas.meyer@chir.imed.uni-erlangen.de
authors.forename: Th
authors.initials: T
authors.lastname: Meyer
authors.forename: S
authors.initials: S
authors.lastname: Merkel
authors.forename: M
authors.initials: M
authors.lastname: Radespiel-Troeger
authors.forename: W
authors.initials: W
authors.lastname: Hohenberger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006044:Goiter, Nodular / Q000601:surgery*; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000637:transplantation; D016105:Parathyroidectomy; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy; D014182:Transplantation, Autologous
vernacular_title: Störungen des Kalziumstoffwechsels nach Schilddrüsenresektionen. Eine Analyse wesentlicher Einflussfaktoren.