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Zentralbl Chir 2020; 145(02): 168-175
DOI: 10.1055/a-0837-1013
Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Risikofaktoren für den permanenten postoperativen Hypoparathyreoidismus

Risk Factors for Permanent Postoperative Hypoparathyreoidism
Erik H. Allemeyer
1   Klinik für Allgemein- u. Viszeralchirurgie mit Sektion Proktologie, Raphaelsklinik Münster, Deutschland
,
Marielle S. Kossow
1   Klinik für Allgemein- u. Viszeralchirurgie mit Sektion Proktologie, Raphaelsklinik Münster, Deutschland
,
Burkhard Riemann
2   Klinik für Nuklearmedizin, Universitätsklinikum Münster, Deutschland
,
Matthias W. Hoffmann
1   Klinik für Allgemein- u. Viszeralchirurgie mit Sektion Proktologie, Raphaelsklinik Münster, Deutschland
› Author Affiliations
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Publication History

Publication Date:
22 February 2019 (online)

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Zusammenfassung

Hintergrund Der permanente postoperative Hypoparathyreoidismus ist die häufigste Komplikation nach einer totalen Thyreoidektomie mit erheblichen möglichen Folgeerkrankungen, Beeinträchtigung der Lebensqualität und hoher sozioökonomischer Bedeutung.

Zielsetzung Identifikation von Risikofaktoren für den permanenten postoperativen Hypoparathyreoidismus.

Material und Methoden 420 Patienten unseres Schilddrüsenzentrums erhielten zwischen 08/2012 und 08/2014 eine totale Thyreoidektomie. 382 gingen in die Studie ein. An einer Follow-up-Untersuchung zwischen 8 und 32 Monaten nach der Operation nahmen 117 teil.

Ergebnisse Mit einem permanenten postoperativen Hypoparathyreoidismus waren assoziiert: erniedrigter PTH-Wert am 1. postoperativen Tag, Verzicht bzw. Nichterfordernis einer Redon-Drainage und eine lange Krankenhausverweildauer. Die Assoziationen waren ausgeprägt, jedoch nicht signifikant.

Diskussion Wir ermittelten Hinweise auf Prädiktoren für den permanenten postoperativen Hypoparathyreoidismus. Eine Validierung als relevante Risikofaktoren sollte in größeren Multicenterstudien erfolgen. Die Kenntnis von Risikofaktoren könnte zur Vermeidung dieser Komplikation und zur gezielten Nachsorgebetreuung gefährdeter Patienten dienen.

Abstract

Background Permanent postoperative hypoparathyreoidism remains the most frequent complication after total thyreoidectomy with severe long-term morbidity, impairment of quality of life and economic implications.

Objective Identification of risk factors for permanent postoperative hypoparathyreoidism.

Material and Methods 420 patients received total thyreoidectomy in our endocrine centre between 08/2012 und 08/2014, of whom 382 were included in the study. 117 patients underwent a follow-up investigation between 8 and 32 months postoperatively.

Results We determined a low parathyroid hormone level on postoperative day 1, non-application of a drain and a prolonged postoperative hospital stay as being associated with permanent postoperative hypoparathyreoidism. No association was found between postoperative hypoparathyroidism and autotransplantation of a parathyroid gland. Associations were strong but not significant.

Discussion We identified associated factors for permanent postoperative hypoparathyreoidism. Larger multicentre studies should be performed for validation as possible relevant risk factors. Knowledge of risk factors might help to avoid this complication and to manage close follow-up and therapy in patients affected.

Schlüsselwörter

permanenter postoperativer Hypoparathyreoidismus - endokrine Chirurgie - Risikofaktoren - Nachsorge nach totaler Thyreoidektomie

Key words

endocrine surgery - permanent postoperative hypoparathyreoidism - risk factors - follow-up - long-term surveillance after thyreoidectomy
 

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