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Hypoparathyroidism after total thyroidectomy in patients with previous gastric bypass

Artikel i vetenskaplig tidskrift
Författare R. A. Droeser
J. Ottosson
Andreas Muth
H. Hultin
K. Lindwall-Ahlander
A. Bergenfelz
M. Almquist
Publicerad i Langenbecks Archives of Surgery
Volym 402
Nummer/häfte 2
Sidor 273-280
ISSN 1435-2443
Publiceringsår 2017
Publicerad vid Institutionen för kliniska vetenskaper, sektionen för kirurgi och kirurgisk gastroforskning, Avdelningen för kirurgi
Sidor 273-280
Språk English
Länkar doi.org/10.1007/s00423-016-1517-x
Ämnesord Total thyroidectomy, Gastric bypass, Postoperative hypoparathyroidism, Cohort study, bariatric surgery, risk-factors, postthyroidectomy hypocalcemia, outpatient thyroidectomy, disease, obesity, safe, Surgery
Ämneskategorier Kirurgi, Gastroenterologi

Sammanfattning

Purpose Case reports suggest that patients with previous gastric bypass have an increased risk of severe hypocalcemia after total thyroidectomy, but there are no population-based studies. The prevalence of gastric bypass before thyroidectomy and the risk of hypocalcemia after thyroidectomy in patients with previous gastric bypass were investigated. Methods By cross-linking The Scandinavian Quality Registry for Thyroid, Parathyroid and Adrenal Surgery with the Scandinavian Obesity Surgery Registry patients operated with total thyroidectomy without concurrent or previous surgery for hyperparathyroidism were identified and grouped according to previous gastric bypass. The risk of treatment with intravenous calcium during hospital stay, and with oral calcium and vitamin D at 6 weeks and 6 months postoperatively was calculated by using multiple logistic regression in the overall cohort and in a 1:1 nested case-control analysis. Results We identified 6115 patients treated with total thyroidectomy. Out of these, 25 (0.4 %) had undergone previous gastric bypass surgery. In logistic regression, previous gastric bypass was not associated with treatment with i.v. calcium (OR 2.05, 95 % CI 0.48-8.74), or calcium and/or vitamin D at 6 weeks (1.14 (0.39-3.35), 1.31 (0.39-4.42)) or 6 months after total thyroidectomy (1.71 (0.40-7.32), 2.28 (0.53-9.75)). In the nested case-control analysis, rates of treatment for hypocalcemia were similar in patients with and without previous gastric bypass. Conclusion Previous gastric bypass surgery was infrequent in patients undergoing total thyroidectomy and was not associated with an increased risk of postoperative hypocalcemia.

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