Influence of Various Operative Thyroid Techniques on Postoperative Hypoparathyroidism at King Hussein Medical City

Anas Aburumman, Mohammad Alhuniti, Yousef Alsardia, Belal Alabdallat, Ali Aloun

Abstract: Background: The main severe risk of thyroid operative techniques is hypoparathyroidism. The frequency percentage of hypoparathyroidism after surgery is 1.6%-50%. In the majority of subjects, this is temporary and only 0.5%-6.6% of subjects might remain with permanent hypoparathyroidism. The operative-induced risk of hypoparathyroidism could be correlated with the size of thyroidectomy influencing hypoparathyroidism after thyroid operative techniques. Aim: To determine the relation between operative thyroid techniques and the risk of postoperative hypoparathyroidism in subjects with thyroid diseases. Methods: Our retrospective investigation included 471 subjects with thyroid surgery for thyroid diseases, of both sexes(women:388 [82.4%], men:83 [17.6%])and aged 35-55yrs.at King Hussein hospital, King Hussein medical city, Amman, JORDAN, during the period 2018-2019. The factors that might affect the risk of hypoparathyroidism such as age and sex were enrolled in the investigation.One-way ANOVA test was used to assess each parameter in groups of operative thyroid techniques. Cox regression was measured to estimate the hazard ratio (HR). Results: Bilateral subtotal (33.3%) was the main frequently used operative technique for thyroid diseases. Nontoxic uni /multinodular goiter is the main frequent disease which needs thyroidectomy (overall = 254/471; 53.9%). 20 subjects (4.2%) with hypoparathyroidism were found. Frequency of hypoparathyroidism was recorded the most in subjects with bilateral total thyroidectomy (4/35; 11.4%) and recorded the least in subjects with unilateral subtotal thyroidectomy (2/82; 2.4%). In subjects with unilateral subtotal, the risk was the most in bilateral total (HR: 10.62), and was the least in bilateral subtotal (HR:1.12). Temporary hypothyroidism was recorded in 15 subjects (75%) and permanent one in 5(25%) subjects. Conclusion: Size of thyroid resection affected the risk of postoperative hypoparathyroidism. Frequency of hypoparathyroidism was recorded the most with bilateral total thyroidectomy and recorded the least with unilateral subtotal thyroidectomy.

Keywords: hypoparathyroidism, operative thyroid technique, thyroid diseases, thyroidectomy