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Hypoparathyroidism after total thyroidectomy in patients with previous gastric bypass
Skane Univ Hosp, Dept Surg, Lund, Sweden..
Univ Orebro, Fac Med & Hlth, Dept Surg, Orebro, Sweden..
Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Surg, Gothenburg, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
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2017 (English)In: Langenbeck's archives of surgery (Print), ISSN 1435-2443, E-ISSN 1435-2451, Vol. 402, no 2, 273-280 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Springer, 2017. Vol. 402, no 2, 273-280 p.
Keyword [en]
Total thyroidectomy, Gastric bypass, Postoperative hypoparathyroidism, Cohort study
National Category
Surgery
Identifiers
URN: urn:nbn:se:uu:diva-320284DOI: 10.1007/s00423-016-1517-xISI: 000397297900011PubMedID: 27783154OAI: oai:DiVA.org:uu-320284DiVA: diva2:1090910
Available from: 2017-04-25 Created: 2017-04-25 Last updated: 2017-04-25Bibliographically approved

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