Links for fulltext
(May Require Subscription)
- Publisher Website: 10.1007/s00268-011-1236-y
- Scopus: eid_2-s2.0-80855123768
- PMID: 21858556
- WOS: WOS:000294807800005
- Find via
Supplementary
- Citations:
- Appears in Collections:
Article: Graves’ Ophthalmopathy as an Indication Increased the Risk of Hypoparathyroidism After Bilateral Thyroidectomy
| Title | Graves’ Ophthalmopathy as an Indication Increased the Risk of Hypoparathyroidism After Bilateral Thyroidectomy |
|---|---|
| Authors | |
| Keywords | Medicine & Public Health Surgery Abdominal Surgery Cardiac Surgery General Surgery Thoracic Surgery Vascular Surgery |
| Issue Date | 2011 |
| Publisher | Springer New York |
| Citation | World Journal of Surgery, 2011, v. 35, n. 10, p. 2212-2218 How to Cite? |
| Abstract | BACKGROUND: Studies have evaluated the effect of thyroidectomy on the course of Graves' ophthalmopathy (GO) but it is unclear how GO as an indication might affect surgical outcomes. We aimed to evaluate the impact of this indication on surgical outcomes in Graves' disease (GD). METHODS: From 1995 to 2008, 329 patients with GD underwent thyroidectomy. Patients were stratified into two groups, namely, those with GO as indication (GO) and those with non-GO indication (non-GO). Outcomes were compared between the groups and outcomes with significance were further analyzed by multivariate analyses to determine independent factors. RESULTS: The GO group was significantly older (P < 0.001), had more males (P < 0.001), and fewer relapses (P < 0.001) than the non-GO group. It also had a higher proportion of total/near-total thyroidectomy (P < 0.001), despite a shorter operating time (P = 0.024) and less blood loss (P = 0.010). When only total/near-total thyroidectomy was considered, the GO group had significantly more permanent hypoparathyroidism than the non-GO group (9.2 vs. 1.6%, P = 0.038), but the rate of permanent hypoparathyroidism was similar in the two groups when only those with parathyroid autotransplantation were considered. Other complications were similar between the two groups. By multivariate analysis, GO as indication was an independent risk factor for temporary (OR 1.97, P = 0.033) and permanent hypoparathyroidism (OR 4.76, P = 0.007). CONCLUSION: GO as a surgical indication (i.e., unstable or active GO requiring ophthalmic treatment or follow-up) was associated with increased risk of temporary and permanent hypoparathyroidism after bilateral thyroidectomy. Routine parathyroid autotransplantation may reduce the risk of permanent hypoparathyroidism in this select patient group. |
| Persistent Identifier | http://hdl.handle.net/10722/144869 |
| ISSN | 2021 Impact Factor: 3.282 2020 SCImago Journal Rankings: 1.115 |
| PubMed Central ID | |
| ISI Accession Number ID | |
| References | Nielsen CH, Brix TH, Leslie RG, Hegedus L (2009) A role for autoantibodies in enhancement of pro-inflammatory cytokine responses to a self-antigen, thyroid peroxidase. Clin Immunol 133(2):218–227 doi: 10.1016/j.clim.2009.07.014 Prabhakar BS, Bahn RS, Smith TJ (2003) Current perspective on the pathogenesis of Graves’ disease and ophthalmopathy. Endocr Rev 24(6):802–835 doi: 10.1210/er.2002-0020 Stalberg P, Svensson A, Hessman O, Akerstrom G, Hellman P (2008) Surgical treatment of Graves’ disease: evidence-based approach. World J Surg 32(7):1269–1277. doi: doi: 10.1007/s00268-008-9497-9 Tominaga T, Yokoyama N, Nagataki S, Cho BY, Koh CS, Chen JL et al (1997) International differences in approaches to 131I therapy for Graves’ disease: case selection and restrictions recommended to patients in Japan, Korea, and China. Thyroid 7(2):217–220 doi: 10.1089/thy.1997.7.217 Wartofsky L, Glinoer D, Solomon B, Nagataki S, Lagasse R, Nagayama Y et al (1991) Differences and similarities in the diagnosis and treatment of Graves’ disease in Europe, Japan, and the United States. Thyroid 1(2):129–135 doi: 10.1089/thy.1991.1.129 Ku CF, Lo CY, Chan WF, Kung AW, Lam KS (2005) Total thyroidectomy replaces subtotal thyroidectomy as the preferred surgical treatment for Graves’ disease. ANZ J Surg 75(7):528–531 doi: 10.1111/j.1445-2197.2005.03441.x Menconi F, Marino M, Pinchera A, Rocchi R, Mazzi B, Nardi M et al (2007) Effects of total thyroid ablation versus near-total thyroidectomy alone on mild to moderate Graves’ orbitopathy treated with intravenous glucocorticoids. J Clin Endocrinol Metab 92(5):1653–1658 doi: 10.1210/jc.2006-1800 Leech NJ, Dayan CM (1998) Controversies in the management of Graves’ disease. Clin Endocrinol (Oxf) 49(3):273–280 doi: 10.1046/j.1365-2265.1998.00558.x Tallstedt L, Lundell G, Torring O, Wallin G, Ljunggren JG, Blomgren H et al (1992) Occurrence of ophthalmopathy after treatment for Graves’ hyperthyroidism The Thyroid Study Group. N Engl J Med 326(26):1733–1738 doi: 10.1056/NEJM199206253262603 Abe Y, Sato H, Noguchi M, Mimura T, Sugino K, Ozaki O et al (1998) Effect of subtotal thyroidectomy on natural history of ophthalmopathy in Graves’ disease. World J Surg 22(7):714–717. doi: doi: 10.1007/s002689900458 Levitt MD, Edis AJ, Agnello R, McCormick CC (1988) The effect of subtotal thyroidectomy on Graves’ ophthalmopathy. World J Surg 12(5):593–597. doi: doi: 10.1007/BF01655858 Hassan L, Danila R, Maurer E, Osei-Agymang T, Zielke A (2008) Severe Graves’ ophthalmopathy may be a factor for the development of postthyroidectomy hypocalcemia. Exp Clin Endocrinol Diabetes 116:614–618 doi: 10.1055/s-2008-1065333 Lang BH, Lo CY (2005) Total thyroidectomy for multinodular goiter in the elderly. Am J Surg 190(3):418–423 doi: 10.1016/j.amjsurg.2005.03.029 Bahn RS, Heufelder AE (1993) Pathogenesis of Graves’ ophthalmopathy. N Engl J Med 329(20):1468–1475 doi: 10.1056/NEJM199311113292007 Yip J, Lang BH, Lo CY (2011) Changing trend in surgical indication and management for Graves’ disease. Am J Surg. doi:10.1016/j.amjsurg.2011.01.029 Miccoli P, Vitti P, Rago T, Iacconi P, Bartalena L, Bogazzi F et al (1996) Surgical treatment of Graves’ disease: subtotal or total thyroidectomy? Surgery 120(6):1020–1024; discussion 1024–1025 doi: 10.1016/S0039-6060(96)80049-3 Palit TK, Miller CC 3rd, Miltenburg DM (2000) The efficacy of thyroidectomy for Graves’ disease: a meta-analysis. J Surg Res 90(2):161–165 doi: 10.1006/jsre.2000.5875 Witte J, Goretzki PE, Dotzenrath C, Simon D, Felis P, Neubauer M et al (2000) Surgery for Graves’ disease: total versus subtotal thyroidectomy—results of a prospective randomized trial. World J Surg 24(11):1303–1311. doi: doi: 10.1007/s002680010216 Abboud B, Sargi Z, Akkam M, Sleilaty F (2002) Risk factors for postthyroidectomy hypocalcemia. J Am Coll Surg 195(4):456–461 doi: 10.1016/S1072-7515(02)01310-8 Lo CY, Lam KY (2001) Routine parathyroid autotransplantation during thyroidectomy. Surgery 129(3):318–323 doi: 10.1067/msy.2001.111125 Thomusch O, Machens A, Sekulla C, Ukkat J, Brauckhoff M, Dralle H (2003) The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surgery 133(2):180–185 doi: 10.1067/msy.2003.61 Abboud B, Sleilaty G, Zeineddine S, Braidy C, Aouad R, Tohme C et al (2008) Is therapy with calcium and vitamin D and parathyroid autotransplantation useful in total thyroidectomy for preventing hypocalcemia? Head Neck 30(9):1148–1154; discussion 1154–1155 doi: 10.1002/hed.20836 Thomusch O, Machens A, Sekulla C, Ukkat J, Lippert H, Gastinger I et al (2000) Multivariate analysis of risk factors for postoperative complications in benign goiter surgery: prospective multicenter study in Germany. World J Surg 24(11):1335–1341. doi: doi: 10.1007/s002680010221 Yamashita H, Noguchi S, Tahara K, Watanabe S, Uchino S, Kawamoto H et al (1997) Postoperative tetany in patients with Graves’ disease: a risk factor analysis. Clin Endocrinol (Oxf) 47(1):71–77 doi: 10.1046/j.1365-2265.1997.2201033.x Gerding MN, van der Meer JW, Broenink M, Bakker O, Wiersinga WM, Prummel MF (2000) Association of thyrotrophin receptor antibodies with the clinical features of Graves’ ophthalmopathy. Clin Endocrinol (Oxf) 52(3):267–271 doi: 10.1046/j.1365-2265.2000.00959.x Eckstein AK, Plicht M, Lax H, Neuhauser M, Mann K, Lederbogen S et al (2006) Thyrotropin receptor autoantibodies are independent risk factors for Graves’ ophthalmopathy and help to predict severity and outcome of the disease. J Clin Endocrinol Metab 91(9):3464–3470 doi: 10.1210/jc.2005-2813 Lang BH, Lo CY (2010) Vitamin D3 deficiency is associated with late-onset hypocalcemia after minimally invasive parathyroidectomy in a vitamin D borderline area. World J Surg 34(6):1350–1355. doi: doi: 10.1007/s00268-009-0377-8 |
| DC Field | Value | Language |
|---|---|---|
| dc.contributor.author | Wong, KP | en_US |
| dc.contributor.author | Lang, BHH | en_US |
| dc.date.accessioned | 2012-02-21T05:44:37Z | - |
| dc.date.available | 2012-02-21T05:44:37Z | - |
| dc.date.issued | 2011 | en_US |
| dc.identifier.citation | World Journal of Surgery, 2011, v. 35, n. 10, p. 2212-2218 | en_US |
| dc.identifier.issn | 0364-2313 | en_US |
| dc.identifier.uri | http://hdl.handle.net/10722/144869 | - |
| dc.description.abstract | BACKGROUND: Studies have evaluated the effect of thyroidectomy on the course of Graves' ophthalmopathy (GO) but it is unclear how GO as an indication might affect surgical outcomes. We aimed to evaluate the impact of this indication on surgical outcomes in Graves' disease (GD). METHODS: From 1995 to 2008, 329 patients with GD underwent thyroidectomy. Patients were stratified into two groups, namely, those with GO as indication (GO) and those with non-GO indication (non-GO). Outcomes were compared between the groups and outcomes with significance were further analyzed by multivariate analyses to determine independent factors. RESULTS: The GO group was significantly older (P < 0.001), had more males (P < 0.001), and fewer relapses (P < 0.001) than the non-GO group. It also had a higher proportion of total/near-total thyroidectomy (P < 0.001), despite a shorter operating time (P = 0.024) and less blood loss (P = 0.010). When only total/near-total thyroidectomy was considered, the GO group had significantly more permanent hypoparathyroidism than the non-GO group (9.2 vs. 1.6%, P = 0.038), but the rate of permanent hypoparathyroidism was similar in the two groups when only those with parathyroid autotransplantation were considered. Other complications were similar between the two groups. By multivariate analysis, GO as indication was an independent risk factor for temporary (OR 1.97, P = 0.033) and permanent hypoparathyroidism (OR 4.76, P = 0.007). CONCLUSION: GO as a surgical indication (i.e., unstable or active GO requiring ophthalmic treatment or follow-up) was associated with increased risk of temporary and permanent hypoparathyroidism after bilateral thyroidectomy. Routine parathyroid autotransplantation may reduce the risk of permanent hypoparathyroidism in this select patient group. | en_US |
| dc.language | eng | en_US |
| dc.publisher | Springer New York | en_US |
| dc.relation.ispartof | World Journal of Surgery | en_US |
| dc.rights | The Author(s) | en_US |
| dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | en_US |
| dc.subject | Medicine & Public Health | en_US |
| dc.subject | Surgery | en_US |
| dc.subject | Abdominal Surgery | en_US |
| dc.subject | Cardiac Surgery | en_US |
| dc.subject | General Surgery | en_US |
| dc.subject | Thoracic Surgery | en_US |
| dc.subject | Vascular Surgery | en_US |
| dc.title | Graves’ Ophthalmopathy as an Indication Increased the Risk of Hypoparathyroidism After Bilateral Thyroidectomy | en_US |
| dc.type | Article | en_US |
| dc.identifier.openurl | http://library.hku.hk:4551/resserv?sid=springerlink&genre=article&atitle=Graves’ Ophthalmopathy as an Indication Increased the Risk of Hypoparathyroidism After Bilateral Thyroidectomy&title=World Journal of Surgery&issn=03642313&date=2011-10-01&volume=35&issue=10& spage=2212&authors=Kai-Pun Wong, Brian Hung-Hin Lang | en_US |
| dc.description.nature | published_or_final_version | en_US |
| dc.identifier.doi | 10.1007/s00268-011-1236-y | en_US |
| dc.identifier.pmid | 21858556 | - |
| dc.identifier.pmcid | PMC3170470 | - |
| dc.identifier.scopus | eid_2-s2.0-80855123768 | en_US |
| dc.identifier.hkuros | 194102 | - |
| dc.relation.references | Nielsen CH, Brix TH, Leslie RG, Hegedus L (2009) A role for autoantibodies in enhancement of pro-inflammatory cytokine responses to a self-antigen, thyroid peroxidase. Clin Immunol 133(2):218–227 | en_US |
| dc.relation.references | doi: 10.1016/j.clim.2009.07.014 | en_US |
| dc.relation.references | Prabhakar BS, Bahn RS, Smith TJ (2003) Current perspective on the pathogenesis of Graves’ disease and ophthalmopathy. Endocr Rev 24(6):802–835 | en_US |
| dc.relation.references | doi: 10.1210/er.2002-0020 | en_US |
| dc.relation.references | Stalberg P, Svensson A, Hessman O, Akerstrom G, Hellman P (2008) Surgical treatment of Graves’ disease: evidence-based approach. World J Surg 32(7):1269–1277. doi: | en_US |
| dc.relation.references | doi: 10.1007/s00268-008-9497-9 | en_US |
| dc.relation.references | Tominaga T, Yokoyama N, Nagataki S, Cho BY, Koh CS, Chen JL et al (1997) International differences in approaches to 131I therapy for Graves’ disease: case selection and restrictions recommended to patients in Japan, Korea, and China. Thyroid 7(2):217–220 | en_US |
| dc.relation.references | doi: 10.1089/thy.1997.7.217 | en_US |
| dc.relation.references | Wartofsky L, Glinoer D, Solomon B, Nagataki S, Lagasse R, Nagayama Y et al (1991) Differences and similarities in the diagnosis and treatment of Graves’ disease in Europe, Japan, and the United States. Thyroid 1(2):129–135 | en_US |
| dc.relation.references | doi: 10.1089/thy.1991.1.129 | en_US |
| dc.relation.references | Ku CF, Lo CY, Chan WF, Kung AW, Lam KS (2005) Total thyroidectomy replaces subtotal thyroidectomy as the preferred surgical treatment for Graves’ disease. ANZ J Surg 75(7):528–531 | en_US |
| dc.relation.references | doi: 10.1111/j.1445-2197.2005.03441.x | en_US |
| dc.relation.references | Menconi F, Marino M, Pinchera A, Rocchi R, Mazzi B, Nardi M et al (2007) Effects of total thyroid ablation versus near-total thyroidectomy alone on mild to moderate Graves’ orbitopathy treated with intravenous glucocorticoids. J Clin Endocrinol Metab 92(5):1653–1658 | en_US |
| dc.relation.references | doi: 10.1210/jc.2006-1800 | en_US |
| dc.relation.references | Leech NJ, Dayan CM (1998) Controversies in the management of Graves’ disease. Clin Endocrinol (Oxf) 49(3):273–280 | en_US |
| dc.relation.references | doi: 10.1046/j.1365-2265.1998.00558.x | en_US |
| dc.relation.references | Tallstedt L, Lundell G, Torring O, Wallin G, Ljunggren JG, Blomgren H et al (1992) Occurrence of ophthalmopathy after treatment for Graves’ hyperthyroidism The Thyroid Study Group. N Engl J Med 326(26):1733–1738 | en_US |
| dc.relation.references | doi: 10.1056/NEJM199206253262603 | en_US |
| dc.relation.references | Abe Y, Sato H, Noguchi M, Mimura T, Sugino K, Ozaki O et al (1998) Effect of subtotal thyroidectomy on natural history of ophthalmopathy in Graves’ disease. World J Surg 22(7):714–717. doi: | en_US |
| dc.relation.references | doi: 10.1007/s002689900458 | en_US |
| dc.relation.references | Levitt MD, Edis AJ, Agnello R, McCormick CC (1988) The effect of subtotal thyroidectomy on Graves’ ophthalmopathy. World J Surg 12(5):593–597. doi: | en_US |
| dc.relation.references | doi: 10.1007/BF01655858 | en_US |
| dc.relation.references | Hassan L, Danila R, Maurer E, Osei-Agymang T, Zielke A (2008) Severe Graves’ ophthalmopathy may be a factor for the development of postthyroidectomy hypocalcemia. Exp Clin Endocrinol Diabetes 116:614–618 | en_US |
| dc.relation.references | doi: 10.1055/s-2008-1065333 | en_US |
| dc.relation.references | Lang BH, Lo CY (2005) Total thyroidectomy for multinodular goiter in the elderly. Am J Surg 190(3):418–423 | en_US |
| dc.relation.references | doi: 10.1016/j.amjsurg.2005.03.029 | en_US |
| dc.relation.references | Bahn RS, Heufelder AE (1993) Pathogenesis of Graves’ ophthalmopathy. N Engl J Med 329(20):1468–1475 | en_US |
| dc.relation.references | doi: 10.1056/NEJM199311113292007 | en_US |
| dc.relation.references | Yip J, Lang BH, Lo CY (2011) Changing trend in surgical indication and management for Graves’ disease. Am J Surg. doi:10.1016/j.amjsurg.2011.01.029 | en_US |
| dc.relation.references | doi: 10.1016/j.amjsurg.2011.01.029 | en_US |
| dc.relation.references | Miccoli P, Vitti P, Rago T, Iacconi P, Bartalena L, Bogazzi F et al (1996) Surgical treatment of Graves’ disease: subtotal or total thyroidectomy? Surgery 120(6):1020–1024; discussion 1024–1025 | en_US |
| dc.relation.references | doi: 10.1016/S0039-6060(96)80049-3 | en_US |
| dc.relation.references | Palit TK, Miller CC 3rd, Miltenburg DM (2000) The efficacy of thyroidectomy for Graves’ disease: a meta-analysis. J Surg Res 90(2):161–165 | en_US |
| dc.relation.references | doi: 10.1006/jsre.2000.5875 | en_US |
| dc.relation.references | Witte J, Goretzki PE, Dotzenrath C, Simon D, Felis P, Neubauer M et al (2000) Surgery for Graves’ disease: total versus subtotal thyroidectomy—results of a prospective randomized trial. World J Surg 24(11):1303–1311. doi: | en_US |
| dc.relation.references | doi: 10.1007/s002680010216 | en_US |
| dc.relation.references | Abboud B, Sargi Z, Akkam M, Sleilaty F (2002) Risk factors for postthyroidectomy hypocalcemia. J Am Coll Surg 195(4):456–461 | en_US |
| dc.relation.references | doi: 10.1016/S1072-7515(02)01310-8 | en_US |
| dc.relation.references | Lo CY, Lam KY (2001) Routine parathyroid autotransplantation during thyroidectomy. Surgery 129(3):318–323 | en_US |
| dc.relation.references | doi: 10.1067/msy.2001.111125 | en_US |
| dc.relation.references | Thomusch O, Machens A, Sekulla C, Ukkat J, Brauckhoff M, Dralle H (2003) The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surgery 133(2):180–185 | en_US |
| dc.relation.references | doi: 10.1067/msy.2003.61 | en_US |
| dc.relation.references | Abboud B, Sleilaty G, Zeineddine S, Braidy C, Aouad R, Tohme C et al (2008) Is therapy with calcium and vitamin D and parathyroid autotransplantation useful in total thyroidectomy for preventing hypocalcemia? Head Neck 30(9):1148–1154; discussion 1154–1155 | en_US |
| dc.relation.references | doi: 10.1002/hed.20836 | en_US |
| dc.relation.references | Thomusch O, Machens A, Sekulla C, Ukkat J, Lippert H, Gastinger I et al (2000) Multivariate analysis of risk factors for postoperative complications in benign goiter surgery: prospective multicenter study in Germany. World J Surg 24(11):1335–1341. doi: | en_US |
| dc.relation.references | doi: 10.1007/s002680010221 | en_US |
| dc.relation.references | Yamashita H, Noguchi S, Tahara K, Watanabe S, Uchino S, Kawamoto H et al (1997) Postoperative tetany in patients with Graves’ disease: a risk factor analysis. Clin Endocrinol (Oxf) 47(1):71–77 | en_US |
| dc.relation.references | doi: 10.1046/j.1365-2265.1997.2201033.x | en_US |
| dc.relation.references | Gerding MN, van der Meer JW, Broenink M, Bakker O, Wiersinga WM, Prummel MF (2000) Association of thyrotrophin receptor antibodies with the clinical features of Graves’ ophthalmopathy. Clin Endocrinol (Oxf) 52(3):267–271 | en_US |
| dc.relation.references | doi: 10.1046/j.1365-2265.2000.00959.x | en_US |
| dc.relation.references | Eckstein AK, Plicht M, Lax H, Neuhauser M, Mann K, Lederbogen S et al (2006) Thyrotropin receptor autoantibodies are independent risk factors for Graves’ ophthalmopathy and help to predict severity and outcome of the disease. J Clin Endocrinol Metab 91(9):3464–3470 | en_US |
| dc.relation.references | doi: 10.1210/jc.2005-2813 | en_US |
| dc.relation.references | Lang BH, Lo CY (2010) Vitamin D3 deficiency is associated with late-onset hypocalcemia after minimally invasive parathyroidectomy in a vitamin D borderline area. World J Surg 34(6):1350–1355. doi: | en_US |
| dc.relation.references | doi: 10.1007/s00268-009-0377-8 | en_US |
| dc.relation.references | Eckstein AK, Lax H, Losch C, Glowacka D, Plicht M, Mann K et al (2007) Patients with severe Graves’ ophthalmopathy have a higher risk of relapsing hyperthyroidism and are unlikely to remain in remission. Clin Endocrinol (Oxf) 67(4):607–612 | en_US |
| dc.identifier.volume | 35 | en_US |
| dc.identifier.issue | 10 | en_US |
| dc.identifier.spage | 2212 | en_US |
| dc.identifier.epage | 2218 | en_US |
| dc.identifier.eissn | 1432-2323 | en_US |
| dc.identifier.isi | WOS:000294807800005 | - |
| dc.description.other | Springer Open Choice, 21 Feb 2012 | en_US |
| dc.identifier.citeulike | 9716783 | - |
| dc.identifier.issnl | 0364-2313 | - |