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Management of Postthyroidectomy Hypoparathyroidism and Its Effect on Hypocalcemia‐Related Complications: A Meta‐Analysis.

Management of Postthyroidectomy Hypoparathyroidism and Its Effect on Hypocalcemia‐Related Complications: A Meta‐Analysis.

Authors :
van Dijk, Sam P. J.
van Driel, M. H. Elise
van Kinschot, Caroline M. J.
Engel, Maarten F. M.
Franssen, Gaston J. H.
van Noord, Charlotte
Visser, W. Edward
Verhoef, Cornelis
Peeters, Robin P.
van Ginhoven, Tessa M.
Source :
Otolaryngology-Head & Neck Surgery; Feb2024, Vol. 170 Issue 2, p359-372, 14p
Publication Year :
2024

Abstract

Objective: The aim of this Meta‐analysis is to evaluate the impact of different treatment strategies for early postoperative hypoparathyroidism on hypocalcemia‐related complications and long‐term hypoparathyroidism. Data Sources: Embase.com, MEDLINE, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and the top 100 references of Google Scholar were searched to September 20, 2022. Review Methods: Articles reporting on adult patients who underwent total thyroidectomy which specified a treatment strategy for postthyroidectomy hypoparathyroidism were included. Random effect models were applied to obtain pooled proportions and 95% confidence intervals. Primary outcome was the occurrence of major hypocalcemia‐related complications. Secondary outcome was long‐term hypoparathyroidism. Results: Sixty‐six studies comprising 67 treatment protocols and 51,096 patients were included in this Meta‐analysis. In 8 protocols (3806 patients), routine calcium and/or active vitamin D medication was given to all patients directly after thyroidectomy. In 49 protocols (44,012 patients), calcium and/or active vitamin D medication was only given to patients with biochemically proven postthyroidectomy hypoparathyroidism. In 10 protocols (3278 patients), calcium and/or active vitamin D supplementation was only initiated in case of clinical symptoms of hypocalcemia. No patient had a major complication due to postoperative hypocalcemia. The pooled proportion of long‐term hypoparathyroidism was 2.4% (95% confidence interval, 1.9‐3.0). There was no significant difference in the incidence of long‐term hypoparathyroidism between the 3 supplementation groups. Conclusions: All treatment strategies for postoperative hypocalcemia prevent major complications of hypocalcemia. The early postoperative treatment protocol for postthyroidectomy hypoparathyroidism does not seem to influence recovery of parathyroid function in the long term. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
01945998
Volume :
170
Issue :
2
Database :
Complementary Index
Journal :
Otolaryngology-Head & Neck Surgery
Publication Type :
Academic Journal
Accession number :
174881672
Full Text :
https://doi.org/10.1002/ohn.594