Hypoparathyroidism Risk After Total Endoscopic Thyroidectomy for Papillary Thyroid Cancer: A Comparison of the Transoral Vestibular and Breast Approaches
Wei Xu, Changsheng Teng, Guoqian Ding, Ning Zhao Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Ning Zhao, Email 13811926363@163.comBackground: This study aimed to compare the risk of hypoparathyroidism betwe...
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| Format: | Article |
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Dove Medical Press
2022-08-01
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| Series: | Cancer Management and Research |
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| Online Access: | https://www.dovepress.com/hypoparathyroidism-risk-after-total-endoscopic-thyroidectomy-for-papil-peer-reviewed-fulltext-article-CMAR |
| _version_ | 1798041841381146624 |
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| author | Xu W Teng C Ding G Zhao N |
| author_facet | Xu W Teng C Ding G Zhao N |
| author_sort | Xu W |
| collection | DOAJ |
| description | Wei Xu, Changsheng Teng, Guoqian Ding, Ning Zhao Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Ning Zhao, Email 13811926363@163.comBackground: This study aimed to compare the risk of hypoparathyroidism between the transoral vestibular approach (TOVA) and the breast approach (BA) in patients undergoing total endoscopic thyroidectomy (TET) for papillary thyroid carcinoma (PTC).Methods: The medical records of 121 PTC patients (all women) who underwent total TET from January 2015 to January 2021 were retrospectively analyzed. Patients were grouped according to surgical approach (BA or TOVA). Clinical status and concentrations of parathyroid hormone (PTH) and calcium were monitored in the perioperative period and 1, 6, and 12 months after surgery.Results: The BA and TOVA groups comprised 101 and 20 patients, respectively. Clinicopathologic and characteristics and surgical data were comparable between the groups. Incidence of transient hypoparathyroidism was significantly lower in the TOVA group than the BA group (10% vs 63.4%; p < 0.01). Incidence of permanent hypoparathyroidism was comparable (5% vs 6.9%). Two days after TET, mean PTH concentration was significantly higher and incidence of abnormal PTH was significantly lower in the TOVA group. The incidence of abnormal calcium concentration 2 days after surgery was significantly lower in the TOVA group. One month after surgery, the mean calcium concentration was significantly higher in the TOVA group. Univariate and multivariate Cox regression analysis suggested that patients who underwent TOVA had a lower risk of transient hypoparathyroidism (hazard ratio 0.05, 95% confidence interval, 0.01– 0.23; p< 0.01). No clinicopathological factors examined were significantly associated with permanent hypoparathyroidism.Conclusion: In patients undergoing TET for PTC, the incidence of transient hypoparathyroidism may be lower with the TOVA than the BA. Surgeons should be aware of the relatively high risk of transient hypoparathyroidism when performing the BA.Keywords: hypoparathyroidism, endoscopic, thyroidectomy, papillary thyroid carcinoma, parathyroid hormone, surgery |
| first_indexed | 2024-04-11T22:27:14Z |
| format | Article |
| id | doaj.art-31752ffb3f3c4f89ae90f4d5739e0cdc |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-04-11T22:27:14Z |
| publishDate | 2022-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj.art-31752ffb3f3c4f89ae90f4d5739e0cdc2022-12-22T03:59:37ZengDove Medical PressCancer Management and Research1179-13222022-08-01Volume 142485249277400Hypoparathyroidism Risk After Total Endoscopic Thyroidectomy for Papillary Thyroid Cancer: A Comparison of the Transoral Vestibular and Breast ApproachesXu WTeng CDing GZhao NWei Xu, Changsheng Teng, Guoqian Ding, Ning Zhao Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Ning Zhao, Email 13811926363@163.comBackground: This study aimed to compare the risk of hypoparathyroidism between the transoral vestibular approach (TOVA) and the breast approach (BA) in patients undergoing total endoscopic thyroidectomy (TET) for papillary thyroid carcinoma (PTC).Methods: The medical records of 121 PTC patients (all women) who underwent total TET from January 2015 to January 2021 were retrospectively analyzed. Patients were grouped according to surgical approach (BA or TOVA). Clinical status and concentrations of parathyroid hormone (PTH) and calcium were monitored in the perioperative period and 1, 6, and 12 months after surgery.Results: The BA and TOVA groups comprised 101 and 20 patients, respectively. Clinicopathologic and characteristics and surgical data were comparable between the groups. Incidence of transient hypoparathyroidism was significantly lower in the TOVA group than the BA group (10% vs 63.4%; p < 0.01). Incidence of permanent hypoparathyroidism was comparable (5% vs 6.9%). Two days after TET, mean PTH concentration was significantly higher and incidence of abnormal PTH was significantly lower in the TOVA group. The incidence of abnormal calcium concentration 2 days after surgery was significantly lower in the TOVA group. One month after surgery, the mean calcium concentration was significantly higher in the TOVA group. Univariate and multivariate Cox regression analysis suggested that patients who underwent TOVA had a lower risk of transient hypoparathyroidism (hazard ratio 0.05, 95% confidence interval, 0.01– 0.23; p< 0.01). No clinicopathological factors examined were significantly associated with permanent hypoparathyroidism.Conclusion: In patients undergoing TET for PTC, the incidence of transient hypoparathyroidism may be lower with the TOVA than the BA. Surgeons should be aware of the relatively high risk of transient hypoparathyroidism when performing the BA.Keywords: hypoparathyroidism, endoscopic, thyroidectomy, papillary thyroid carcinoma, parathyroid hormone, surgeryhttps://www.dovepress.com/hypoparathyroidism-risk-after-total-endoscopic-thyroidectomy-for-papil-peer-reviewed-fulltext-article-CMARhypoparathyroidismendoscopicthyroidectomypapillary thyroid carcinomaparathyroid hormonesurgery |
| spellingShingle | Xu W Teng C Ding G Zhao N Hypoparathyroidism Risk After Total Endoscopic Thyroidectomy for Papillary Thyroid Cancer: A Comparison of the Transoral Vestibular and Breast Approaches Cancer Management and Research hypoparathyroidism endoscopic thyroidectomy papillary thyroid carcinoma parathyroid hormone surgery |
| title | Hypoparathyroidism Risk After Total Endoscopic Thyroidectomy for Papillary Thyroid Cancer: A Comparison of the Transoral Vestibular and Breast Approaches |
| title_full | Hypoparathyroidism Risk After Total Endoscopic Thyroidectomy for Papillary Thyroid Cancer: A Comparison of the Transoral Vestibular and Breast Approaches |
| title_fullStr | Hypoparathyroidism Risk After Total Endoscopic Thyroidectomy for Papillary Thyroid Cancer: A Comparison of the Transoral Vestibular and Breast Approaches |
| title_full_unstemmed | Hypoparathyroidism Risk After Total Endoscopic Thyroidectomy for Papillary Thyroid Cancer: A Comparison of the Transoral Vestibular and Breast Approaches |
| title_short | Hypoparathyroidism Risk After Total Endoscopic Thyroidectomy for Papillary Thyroid Cancer: A Comparison of the Transoral Vestibular and Breast Approaches |
| title_sort | hypoparathyroidism risk after total endoscopic thyroidectomy for papillary thyroid cancer a comparison of the transoral vestibular and breast approaches |
| topic | hypoparathyroidism endoscopic thyroidectomy papillary thyroid carcinoma parathyroid hormone surgery |
| url | https://www.dovepress.com/hypoparathyroidism-risk-after-total-endoscopic-thyroidectomy-for-papil-peer-reviewed-fulltext-article-CMAR |
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