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Hypoparathyroidism after total thyroidectomy in patients with previous gastric bypass

Droeser, Raoul A.; Ottosson, Johan; Muth, Andreas; Hultin, Hella; Lindwall-Åhlander, Karin; Bergenfelz, Anders LU and Almquist, Martin LU (2017) In Langenbeck's Archives of Surgery 402(2). p.273-280
Abstract

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,... (More)

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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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cohort study, Gastric bypass, Postoperative hypoparathyroidism, Total thyroidectomy
in
Langenbeck's Archives of Surgery
volume
402
issue
2
pages
8 pages
publisher
Springer
external identifiers
  • scopus:84992337493
  • wos:000397297900011
ISSN
1435-2443
DOI
10.1007/s00423-016-1517-x
language
English
LU publication?
yes
id
a0c64483-e8da-4490-9ffe-1cadfcedda49
date added to LUP
2016-11-08 08:29:03
date last changed
2018-01-07 11:34:02
@article{a0c64483-e8da-4490-9ffe-1cadfcedda49,
  abstract     = {<p>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.</p>},
  author       = {Droeser, Raoul A. and Ottosson, Johan and Muth, Andreas and Hultin, Hella and Lindwall-Åhlander, Karin and Bergenfelz, Anders and Almquist, Martin},
  issn         = {1435-2443},
  keyword      = {Cohort study,Gastric bypass,Postoperative hypoparathyroidism,Total thyroidectomy},
  language     = {eng},
  number       = {2},
  pages        = {273--280},
  publisher    = {Springer},
  series       = {Langenbeck's Archives of Surgery},
  title        = {Hypoparathyroidism after total thyroidectomy in patients with previous gastric bypass},
  url          = {http://dx.doi.org/10.1007/s00423-016-1517-x},
  volume       = {402},
  year         = {2017},
}