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Postoperative Hypoparathyroidism

  • Francesco TonelliEmail author
  • Francesco Giudici
Chapter

Abstract

The most common cause of acquired hypoparathyroidism is surgery on the thyroid or parathyroid glands. Symptomatic hypocalcemia after thyroidectomy is most commonly caused by removal of or damage to the parathyroid glands. Total thyroidectomy, surgery for hyperparathyroidism, and lack of identification of parathyroid glands during surgery are the main potential risks for hypoparathyroidism; meanwhile, autografting of parathyroid glands during thyroidectomy can significantly reduce this risk. The main cause of hypoparathyroidism after parathyroidectomy for primary hyperparathyroidism is functional suppression of the normal parathyroid glands by hypercalcemia caused by the pathological excised one. Persistent hypoparathyroidism is rare but possible if bilateral neck exploration, total or subtotal parathyroidectomy for familial hyperparathyroidism, or repetitive surgery is performed.

Keywords

Surgery Thyroidectomy Parathyroidectomy Calcium Hypoparathyroidism Hypocalcemia MEN1 

References

  1. 1.
    Falk SA (1990) Complications of thyroid surgery. Hypocalcemia and hypoparathyroidism; hypocalcitonemia, Chapter 38. In: Falk SA (ed) Thyroid disease: endocrinology, surgery, nuclear medicine, and radiotherapy. Raven Press, Ltd, New YorkGoogle Scholar
  2. 2.
    Lo CY (2000) Parathyroid autotransplantation during thyroidectomy. ANZ J Surg 72:902–907Google Scholar
  3. 3.
    Rude RK, Singer FR (1981) Magnesium deficiency and excess. Annu Rev Med 32:245–259PubMedGoogle Scholar
  4. 4.
    Coburn JW, Massry SG, Kleeman CR (1970) The effect of calcium infusion on renal handling of magnesium with normal and reduced glomerulal filtration rate. Nephron 7:131–143PubMedGoogle Scholar
  5. 5.
    Wilkin TJ, Isles TE, Paterson CR et al (1977) Postthyroidectomy hypocalcemia: a feature of operation or the thyroid disorder? Lancet 1:621–623PubMedGoogle Scholar
  6. 6.
    Kirkby-Bott J, Markogiannakis H, Skandarajah A et al (2011) Preoperative vitamin D deficiency predicts postoperative hypocalcemia after total thyroidectomy. World J Surg 35:324–330PubMedGoogle Scholar
  7. 7.
    Erbil Y, Barbaros U, Temel B et al (2009) The impact of age, vitamin D(3) level, and incidental parathyroidectomy on postoperative hypocalcemia after total or near total thyroidectomy. Am J Surg 197:439–446PubMedGoogle Scholar
  8. 8.
    Hallgrimsson P, Nordenstrom E, Almquist M et al (2012) Risk factors for medically treated hypocalcemia after surgery for Graves’s disease: a Swedish multicenter study of 1,157 patients. World J Surg 36:1933–1942PubMedGoogle Scholar
  9. 9.
    Lang BH, Wong KP, Cowling BJ et al (2013) Do low preoperative vitamin D levels reduce the accuracy of quick parathyroid hormone in predicting postthyroidectomy hypocalcemia? Ann Surg Oncol 20:739–745PubMedCentralPubMedGoogle Scholar
  10. 10.
    Asari R, Passler C, Kaczireh K et al (2008) Hypoparathyroidism after total thyroidectomy. A prospective study. Arch Surg 143:132–137PubMedGoogle Scholar
  11. 11.
    Lo CY, Lam KY (2001) Routine parathyroid autotransplantation during thyroidectomy. Surgery 129:318–323PubMedGoogle Scholar
  12. 12.
    Claussen MS, Pehling GB, Kisken WA (1993) Delayed recovery from post-thyroidectomy hypoparathyroidism: a case report. Wis Med J 92:331–334PubMedGoogle Scholar
  13. 13.
    Sitges-Serra A, Ruiz S, Girvent M et al (2010) Outcome of protracted hypoparathyroidism after total thyroidectomy. Br J Surg 97:1687–1695PubMedGoogle Scholar
  14. 14.
    Cusano NE, Anderson L, Rubin MR et al (2013) Recovery of parathyroid hormone secretion and function in postoperative hypoparathyroidism: a case series. J Clin Endocrinol Metab 98:4285–4290PubMedCentralPubMedGoogle Scholar
  15. 15.
    Pappalardo G, Guadalaxara A, Frattaroli FM et al (1998) Total compared with subtotal thyroidectomy in benign nodular disease: personal series and review of published reports. Eur J Surg 164:501–506PubMedGoogle Scholar
  16. 16.
    Thomusch O, Machens A, Sekulla C et al (2003) The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surgery 133:180–185PubMedGoogle Scholar
  17. 17.
    RiosZambudo A, Rodriguez J, Riquelme J et al (2004) Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery. Ann Surg 240:18–25Google Scholar
  18. 18.
    Colak T, Akca T, Kanik A et al (2004) Total versus subtotal thyroidectomy for the management of benign multinodular goiter in an endemic region. ANZ J Surg 74:974–978PubMedGoogle Scholar
  19. 19.
    Lombardi CP, Raffaelli M, Princi P et al (2006) Parathyroid hormone levels 4 hours after surgery do not accurately predict post-thyroidectomy hypocalcemia. Surgery 140:1016–1025PubMedGoogle Scholar
  20. 20.
    Testini M, Rosato L, Avenia N et al (2007) The impact of single parathyroid gland autotransplantation during thyroid surgery on postoperative hypoparathyroidism: a multicenter study. Transplant Proc 39:225–230PubMedGoogle Scholar
  21. 21.
    Toniato A, Merante Boschin I, Piotto A et al (2008) Thyroidectomy and parathyroid hormone: tracing hypocalcemia-prone patients. Am J Surg 196:285–288PubMedGoogle Scholar
  22. 22.
    Barczynski M, Cichon S, Konturek A et al (2008) Applicability of intraoperative parathyroid hormone assay during total thyroidectomy as a guide for the surgeon to selective parathyroid tissue autotransplantation. World J Surg 32:822–828PubMedGoogle Scholar
  23. 23.
    Di Fabio F, Casella C, Bugari G et al (2006) Identification of patients at low risk for thyroidectomy-related hypocalcemia by intraoperative quick PTH. World J Surg 30:1428–1433PubMedGoogle Scholar
  24. 24.
    Berghenfelz A, Jansson S, Kristofferson A et al (2008) Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients. Langenbeckes Arch Surg 393:667–673Google Scholar
  25. 25.
    Cayo AK, Yen T, Misustin SM et al (2012) Predicting the need for calcium and calcitriol supplementation after total thyroidectomy: Results of a prospective, randomized study. Surgery 152:1059–1567PubMedGoogle Scholar
  26. 26.
    De Andrade Sousa A, Porcaro Salles JM, Arantes Soares JM et al (2012) Predictors factors for post-thyroidectomy hypocalcemia. Rev Col Bras Cir 39:476–482Google Scholar
  27. 27.
    Salinger EM, Moore JT (2013) Perioperative indicators oh hypocalcemia in total thyroidectomy: the role of vitamin D and parathyroid hormone. Am J Surg 206:876–882PubMedGoogle Scholar
  28. 28.
    Rayes N, Steinmuller T, Schroder S et al (2013) Bilateral subtotal thyroidectomy versus hemithyroidectomy plus subtotal resection (Dunhill procedure) for benign goiter: long-term results of a prospective, randomized study. World J Surg 37:84–90PubMedGoogle Scholar
  29. 29.
    Julián MT, Balibrea JM, Granada ML et al (2013) Intact parathyroid hormone measurement at 24 hours after thyroid surgery as predictor of parathyroid function at long term. Am J Surg 206:783–789PubMedGoogle Scholar
  30. 30.
    Gonzales Botas JH, Lourido Pietrahita D (2013) Hypocalcemia after total thyroidectomy: incidence, control and treatment. Acta Otorrinolaringol Esp 64:102–107Google Scholar
  31. 31.
    Prim MP, de Diego JI, Hardisson D et al (2001) Factors related to nerve injury and hypocalcemia in thyroid gland surgery. Otolaryngol Head Neck Surg 124:111–114PubMedGoogle Scholar
  32. 32.
    Yamashita H, Noguchi S, Murakami T et al (2000) Calcium and its regulating hormones in patients with Graves disease: sex differences and relation to postoperative tetany. Eur J Surg 166:924–928PubMedGoogle Scholar
  33. 33.
    Mc Henry CR, Speroff T, Wintworth D et al (1994) Risk factors for postthyroidectomy hypocalcemia. Surgery 116:641–648Google Scholar
  34. 34.
    Rosato L, Avenia N, Bernante P et al (2004) Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg 28:271–276PubMedGoogle Scholar
  35. 35.
    Tezelman S, Borucu I, Senyurek Y et al (2009) The change in surgical practice from subtotal to near-total or total thyroidectomy in the treatment of patients with benign multinodular goiter. World J Surg 33:400–405PubMedGoogle Scholar
  36. 36.
    Gulcelik MA, Kuru B, Dincer H et al (2012) Complications of completion versus total thyroidectomy. Asian Pac J Cancer Prev 13:5225–5229PubMedGoogle Scholar
  37. 37.
    Thompson NW, Harness JK (1970) Complications of total thyroidectomy for carcinoma. Surg Gynecol Obstet 131:861–868PubMedGoogle Scholar
  38. 38.
    Kim MK, Mandel SH, Baloch Z et al (2004) Morbidity following central compartment reoperation for recurrent or persistent thyroid cancer. Arch Otolaryngol Head Neck Surg 130:1214–1216PubMedGoogle Scholar
  39. 39.
    Paek SH, Lee YM, Min SY et al (2013) Risk factors of hypoparathyroidism following total thyroidectomy for thyroid cancer. World J Surg 37:94–101PubMedGoogle Scholar
  40. 40.
    Hammerstad SS, Norheim I, Paulsen T et al (2013) Excessive decrease in serum magnesium after total thyroidectomy for Graves’s disease is related to development of permanent hypocalcemia. World J Surg 37:369–375PubMedGoogle Scholar
  41. 41.
    Palit TK, Miller CC, Miltenburg DM (2000) The efficacy of thyroidectomy for Graves’s disease: a meta-analysis. J Surg Res 24:1303–1311Google Scholar
  42. 42.
    Al-Adhami A, Snaith AC, Craig WL et al (2013) Changing trends ion surgery for Graves’s disease: a cohort comparison of those having surgery intended to preserve thyroid function with those having ablative surgery. J Otolaryngol Head Neck Surg 42:37PubMedCentralPubMedGoogle Scholar
  43. 43.
    Pfleideree AG, Ahmad N, Dreaper MR et al (2009) The timing of calcium measurement in helping to predict temporary or permanent hypocalcaemia in patients having completion and total thyroidectomy. Ann R Coll Surg Engl 91:140–146Google Scholar
  44. 44.
    Kim YS (2012) Impact of preserving the parathyroid glands on hypocalcemia after total thyroidectomy with neck dissection. J Korean Surg Soc 83:75–82PubMedCentralPubMedGoogle Scholar
  45. 45.
    Attie JN, Khafif RA (1975) Preservation of parathyroid glands during total thyroidectomy. Improved technic utilizing microsurgery. Am J Surg 130:399–404PubMedGoogle Scholar
  46. 46.
    Olson JA Jr, De Benedetti MK, Baumann DS et al (1996) Parathyroid autotransplantation during thyroidectomy. Results of long-term follow-up. Ann Surg 223:472–478PubMedCentralPubMedGoogle Scholar
  47. 47.
    Halsted W (1907) Hypoparathyroidism, status parathyreoprivus, and transplantation of the parathyroid glands. Am J Med Sci 134:1–5Google Scholar
  48. 48.
    Carter WB, Uy K, Ward MD et al (2000) Parathyroid-induced angiogenesis is VEGF-dependent. Surgery 128:458–464PubMedGoogle Scholar
  49. 49.
    D’Avanzo A, Parangi S, Morita E et al (2000) Hyperparathyroidism after thyroid surgery and autotransplantation of histologically normal parathyroid glands. J Am Coll Surg 190:546–552PubMedGoogle Scholar
  50. 50.
    Lo CY, Lam SC (2001) Parathyroid autotransplantation during thyroidectomy: documentation of graft function. Arch Surg 136:1381–1385PubMedGoogle Scholar
  51. 51.
    Paloyan E, Lawrence AM, Paloyan D (1977) Successful autotransplantation of the parathyroid glands during total thyroidectomy for carcinoma. Surg Gynecol Obstet 145:364–368PubMedGoogle Scholar
  52. 52.
    Zedenius J, Wadstrom C, Delbridge L (1999) Routine autotransplantation of at least one parathyroid gland during total thyroidectomy may reduce permanent hypoparathyroidism to zero. Aust N Z J Surg 69:794–799PubMedGoogle Scholar
  53. 53.
    Gauger PG, Reeve TS, Wilkinson M et al (2000) Routine parathyroid autotransplantation during total thyroidectomy: the influence of technique. Eur J Surg 166:605–609PubMedGoogle Scholar
  54. 54.
    Kikumori T, Imai T, Tanaka Y et al (1999) Parathyroid autotransplantation with total thyroidectomy for thyroid carcinoma: long-term follow-up of grafted parathyroid function. Surgery 125:504–508PubMedGoogle Scholar
  55. 55.
    Gao W, Liu L, Ye G et al (2013) Application of minimally invasive video-assisted technique in papillary thyroid microcarcinoma. Surg Laparosc Endosc Percutan Tech 23:468–473PubMedGoogle Scholar
  56. 56.
    Kuboki A, Nakayama T, Konno W et al (2013) New technique using energy-based device versus conventional technique in open thyroidectomy. Auris Nasus Larynx 40:558–562PubMedGoogle Scholar
  57. 57.
    Lombardi CP, Raffaelli M, Princi P et al (2004) Early prediction of postthyroidectomy hypocalcemia by one single iPTH measurement. Surgery 136:1236–1241PubMedGoogle Scholar
  58. 58.
    Barczynski M, Cichon S, Konturek A (2007) Which criterion of intraoperative iPTH assay is the most accurate in prediction of true serum calcium levels after thyroid surgery? Langenbecks Arch Surg 392:693–698PubMedGoogle Scholar
  59. 59.
    Mc Leod IK, Arciero C, Noordzij JP et al (2006) The use of rapid parathyroid hormone assay in predicting postoperative hypocalcemia after total or completion thyroidectomy. Thyroid 16:259–265Google Scholar
  60. 60.
    Scurry WC, Beus KS, Hollenbeak CS et al (2005) Perioperative parathyroid hormone assay for diagnosis and management of postthyroidectomy hypocalcemia. Laryngoscope 115:1362–1366PubMedGoogle Scholar
  61. 61.
    Australian Endocrine Surgeons Guidelines AES06/01 (2007) Postoperative parathyroid hormone measurement and early discharge after total thyroidectomy. Analysis of Australian data and management recommendations. ANZ J Surg 77:199–202Google Scholar
  62. 62.
    Tartaglia F, Giuiani A, Sgueglia M et al (2005) Randomized study on oral administration of calcitriol to prevent symptomatic hypocalcemia after total thyroidectomy. Am J Surg 190:424–429PubMedGoogle Scholar
  63. 63.
    Carter Y, Chen H, Sippel RS (2014) An intact parathyroid hormone-based protocol for the prevention and treatment of symptomatic hypocalcemia after thyroidectomy. J Surg Res 186:23–28PubMedGoogle Scholar
  64. 64.
    Kaplan EL, Bartlett S, Sugimoto J et al (1982) Relation of postoperative hypocalcemia to operative techniques: deleterious effect of excessive use of parathyroid biopsy. Surgery 92:827–834PubMedGoogle Scholar
  65. 65.
    Zamboni WA, Folse R (1986) Adenoma weight: a predictor of transient hypocalcemia after parathyroidectomy. Am J Surg 152:611–615PubMedGoogle Scholar
  66. 66.
    Thompson GB, Grant CS, Perrier ND et al (1999) Reoperative parathyroid surgery in the era of sestamibi scanning and intraoperative parathyroid hormone monitoring. Arch Surg 134:699–704PubMedGoogle Scholar
  67. 67.
    Westerdal J, Lindblom P, Valdemarsson S et al (2000) Risk factors for postoperative hypocalcemia after surgery for primary hyperparathyroidism. Arch Surg 135:142–147Google Scholar
  68. 68.
    Bergenfelz A, Lindblom P, Tibblin S et al (2002) Unilateral versus bilateral neck exploration for primary hyperparathyroidism: a prospective randomized controlled trial. Ann Surg 236:543–551PubMedCentralPubMedGoogle Scholar
  69. 69.
    Burkey SH, Van Heerden JA, Farley DR et al (2002) Will directed parathyroidectomy utilizing the gamma probe or intraoperative parathyroid hormone assay replace bilateral cervical exploration as the preferred operation for primary hyperparathyroidism? World J Surg 26:914–920PubMedGoogle Scholar
  70. 70.
    Lew JI, Solorzano CC, Irvin GL 3rd (2006) Long-term results of parathyroidectomy for hypercalcemic crisis. Arch Surg 141:696–700PubMedGoogle Scholar
  71. 71.
    Norman JG, Politz DE (2007) Safety of immediate discharge after parathyroidectomy: a prospective study of 3,000 consecutive patients. Endocr Pract 13:105–113PubMedGoogle Scholar
  72. 72.
    Allendorf J, DiGorgi M, Spanknebel K et al (2007) 1112 consecutive bilateral neck explorations for primary hyperparathyroidism. World J Surg 31:2075–2080PubMedGoogle Scholar
  73. 73.
    Richards ML, Thompson GB, Farley DR et al (2008) Reoperative parathyroidectomy in 228 patients during the era of minimal-access surgery and intraoperative parathyroid hormone monitoring. Am J Surg 196:937–943PubMedGoogle Scholar
  74. 74.
    Young VN, Osborne KM, Fleming MM et al (2010) Parathyroidectomy in the elderly population: does age really matter? Laryngoscope 120:247–252PubMedGoogle Scholar
  75. 75.
    Hessman O, Westerdahl J, Al-Suliman N et al (2010) Randomized clinical trial comparing open with video-assisted minimally invasive parathyroid surgery for primary hyperparathyroidism. Br J Surg 97:177–184PubMedGoogle Scholar
  76. 76.
    Udelsman R, Lin Z, Donovan P (2011) The superiority of minimally invasive parathyroidectomy based on 1650 consecutive patients with primary hyperparathyroidism. Ann Surg 253:585–591PubMedGoogle Scholar
  77. 77.
    Steen S, Rabeler B, Fisher T et al (2009) Predictive factors for early postoperative hypocalcemia after surgery for primary hyperparathyroidism. Proc (Bayl Univ Med Cent) 22:124–127Google Scholar
  78. 78.
    Brasier AR, Nussbaum SR (1988) Hungry bone syndrome: clinical and biochemical predictors of its occurrence after parathyroid surgery. Am J Med 84:654–660PubMedGoogle Scholar
  79. 79.
    Heath DA, Van’t Hoff W, Barnes AD et al (1979) Value of 1-a-hydroxy vitamin D3 in treatment of primary hyperparathyroidism before parathyroidectomy. BMJ 1:450–452PubMedCentralPubMedGoogle Scholar
  80. 80.
    Chia SH, Weisman RA, Tieu D et al (2006) Prospective study of perioperative factors predicting hypocalcemia after thyroid and parathyroid surgery. Arch Otolaryngol Head Neck Surg 132:41–45PubMedGoogle Scholar
  81. 81.
    Brossard JH, Garon J, Lepage R et al (1993) Inhibition of 1,25(OH)2D production by hypercalcemia in osteitis fibrosa cystica: influence on parathyroid hormone secretion and hungry bone disease. Bone Miner 23:15–26PubMedGoogle Scholar
  82. 82.
    Witteveen JE, van Thiel S, Romijn JA et al (2013) Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature. Eur J Endocrinol 168:45–53Google Scholar
  83. 83.
    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 34:1350–1355PubMedGoogle Scholar
  84. 84.
    Wong WK, Wong NA, Farndon JR (1996) Early postoperative plasma calcium concentration as a predictor of the need for calcium supplement after parathyroidectomy. Br J Surg 83:532–534PubMedGoogle Scholar
  85. 85.
    Kaplan EL, Yashiro T, Salti G (1992) Primary hyperparathyroidism in the 1990s. Choice of surgical procedures for this disease. Ann Surg 215:300–317PubMedCentralPubMedGoogle Scholar
  86. 86.
    Karakas E, Müller HH, Schlosshauer T et al (2013) Reoperations for primary hyperparathyroidism – improvement of outcome over two decades. Langenbecks Arch Surg 398:99–106PubMedGoogle Scholar
  87. 87.
    Chapuis Y, Fulla Y, Bonnichon P et al (1996) Values of ultrasonography, sestamibi scintigraphy and intraoperative measurement of 1–84 PTH for unilateral neck exploration of primary hyperparathyroidism. World J Surg 20:835–840PubMedGoogle Scholar
  88. 88.
    Koslin DB, Adams J, Andersen P et al (1997) Preoperative evaluation of patients with primary hyperparathyroidism: role of high-resolution ultrasound. Laryngoscope 107:1249–1253PubMedGoogle Scholar
  89. 89.
    Inabnet WB, Fulla Y, Richard B et al (1999) Unilateral neck exploration under local anesthesia: the procedure of choice for asymptomatic primary hyperparathyroidism. Surgery 126:1004–1009PubMedGoogle Scholar
  90. 90.
    Tsukamoto E, Russell CF, Fergurson WR et al (1995) The role of preoperative thallium-technetium subtraction scintigraphy in the surgical management of patients with solitary parathyroid adenoma. Clin Radiol 50:677–680PubMedGoogle Scholar
  91. 91.
    Borley NR, Collins RE, O’Doherty M et al (1996) Technetium-99 m sestamibi is accurate enough for scan-directed unilateral neck exploration. Br J Surg 83:989–991PubMedGoogle Scholar
  92. 92.
    Carty SE, Worsey J, Virji MA et al (1997) Concise parathyroidectomy: the impact of preoperative SPECT 99mTc sestamibi scanning and intraoperative quick parathormone assay. Surgery 122:1107–1116PubMedGoogle Scholar
  93. 93.
    Bergenfelz A, Algotsson L, Ahrén B et al (1992) Surgery for primary hyperparathyroidism performed under local anaesthesia. Br J Surg 79:931–934PubMedGoogle Scholar
  94. 94.
    Chen H, Sokoll LJ, Udelsman R (1999) Outpatient minimally invasive parathyroidectomy: a combination of sestamibi-SPECT localization, cervical block anesthesia, and intraoperative parathyroid hormone assay. Surgery 126:1016–1021PubMedGoogle Scholar
  95. 95.
    Nussbaum S, Thompson A, Hutcheson K et al (1988) Intraoperative measurement of parathyroid hormone in the surgical management of hyperparathyroidism. Surgery 104:1121–1127PubMedGoogle Scholar
  96. 96.
    Bergenfelz A, Nordén NE, Ahrén B (1991) Intraoperative fall in plasma levels of intact parathyroid hormone after removal of one enlarged parathyroid gland in hyperparathyroid patients. Eur J Surg 157:109–112PubMedGoogle Scholar
  97. 97.
    Bergenfelz A, Isaksson A, Ahrén B (1994) Intraoperative monitoring of intact PTH during surgery for primary hyperparathyroidism. Langenbecks Arch Surg 379:178–181Google Scholar
  98. 98.
    Bergenfelz A, Isaksson A, Lindblom P et al (1998) Measurement of parathyroid hormone in patients with primary hyperparathyroidism undergoing first an reoperative surgery. Br J Surg 85:1129–1132PubMedGoogle Scholar
  99. 99.
    Irvin GL, Prudhomme DL, Deriso GT et al (1994) A new approach to parathyroidectomy. Ann Surg 219:574–579PubMedCentralPubMedGoogle Scholar
  100. 100.
    Worsey MJ, Carty SE, Watson CG (1993) Success of unilateral neck exploration for sporadic primary hyperparathyroidism. Surgery 114:1024–1030PubMedGoogle Scholar
  101. 101.
    Tibblin S, Bondeson AG, Bondeson L et al (1984) Surgical strategy in hyperparathyroidism due to solitary adenoma. Ann Surg 200:776–784PubMedCentralPubMedGoogle Scholar
  102. 102.
    Tibblin S, Bizard JP, Bondeson AG et al (1991) Primary hyperparathyroidism due to solitary adenoma. A comparative multicentre study of early and long-term results of different surgical regimens. Eur J Surg 157:511–515PubMedGoogle Scholar
  103. 103.
    Irvin GL III, Molinari AS, Figueroa C et al (1999) Improved success rate in reoperative parathyroidectomy with intraoperative PTH assay. Ann Surg 229:874–878PubMedCentralPubMedGoogle Scholar
  104. 104.
    Sebag F, Shen W, Brunaud L et al (2003) Intraoperative parathyroid hormone assay and parathyroid reoperations. Surgery 134:1049–1055PubMedGoogle Scholar
  105. 105.
    Tonelli F, Giudici F, Cavalli T et al (2012) Surgical approach in patients with hyperparathyroidism in multiple endocrine neoplasia type 1: total versus partial parathyroidectomy. Clinics (Sao Paulo) 1:155–160Google Scholar
  106. 106.
    Tonelli F, Marcucci T, Fratini G et al (2007) Is total parathyroidectomy the treatment of choice for hyperparathyroidism in multiple endocrine neoplasia type 1? Ann Surg 246:1075–1082PubMedGoogle Scholar
  107. 107.
    Tonelli F, Marcucci T, Giudici F et al (2009) Surgical approach in hereditary hyperparathyroidism. Endocr J 56:827–841PubMedGoogle Scholar
  108. 108.
    Schlosser K, Veit JA, Witte S et al (2007) Comparison of total parathyroidectomy without autotransplantation and without thymectomy versus total parathyroidectomy with autotransplantation and with thymectomy for secondary hyperparathyroidism: TOPAR PILOT-Trial. Trials 8:22PubMedCentralPubMedGoogle Scholar
  109. 109.
    Riss P, Asari R, Scheuba C et al (2013) Current trends in surgery for renal hyperparathyroidism (RHPT) – an international survey. Langenbecks Arch Surg 398:121–130PubMedGoogle Scholar
  110. 110.
    Saliba W, El-Haddad B (2009) Secondary hyperparathyroidism: pathophysiology and treatment. J Am Board Fam Med 22:574–581PubMedGoogle Scholar
  111. 111.
    Schneider R, Slater EP, Karakas E et al (2012) Initial parathyroid surgery in 606 patients with renal hyperparathyroidism. World J Surg 36:318–326PubMedGoogle Scholar
  112. 112.
    Roshan A, Kamath B, Roberts S et al (2006) Intra-operative parathyroid hormone monitoring in secondary hyperparathyroidism: is it useful? Clin Otolaryngol 31:198–203PubMedGoogle Scholar
  113. 113.
    Andress DL (2008) Adynamic bone in patients with chronic kidney disease. Kidney Int 73:1345–1354PubMedGoogle Scholar
  114. 114.
    National Kidney Foundation (2003) K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 42:S1–S201Google Scholar
  115. 115.
    Rothmund M, Wagner PK (1984) Assessment of parathyroid graft function after autotransplantation of fresh and cryopreserved tissue. World J Surg 8:527–533PubMedGoogle Scholar
  116. 116.
    Wells SA Jr, Farndon JR, Dale JK et al (1980) Long-term evaluation of patients with primary parathyroid hyperplasia managed by total parathyroidectomy and heterotopic autotransplantation. Ann Surg 192:451–458PubMedCentralPubMedGoogle Scholar
  117. 117.
    Wells SA Jr, Gunnells JC, Gutman RA et al (1977) The successful transplantation of frozen parathyroid tissue in man. Surgery 81:86–90PubMedGoogle Scholar
  118. 118.
    Shoback D (2008) Clinical practice. Hypoparathyroidism. N Engl J Med 359:391–403PubMedGoogle Scholar
  119. 119.
    Lo Galbo AM, Kuik DJ, Lips P et al (2013) A prospective longitudinal study on endocrine dysfunction following treatment of laryngeal or hypopharyngeal carcinoma. Oral Oncol 49:950–955PubMedGoogle Scholar
  120. 120.
    Basheeth N, O’Cathain E, O’Leary G et al (2014) Hypocalcemia after total laryngectomy: incidence and risk factors. Laryngoscope 124:1128–1133. doi: 10.1002/lary.24429 PubMedGoogle Scholar
  121. 121.
    Thorp MA, Levitt NS, Mortimore S et al (1999) Parathyroid and thyroid function five years after treatment of laryngeal and hypopharyngeal carcinoma. Clin Otolaryngol Allied Sci 24:104–108PubMedGoogle Scholar
  122. 122.
    Martins AS, Tincani AJ (2006) Thyroidectomy and hypoparathyroidism in patients with pharyngoesophageal tumors. Head Neck 28:135–141PubMedGoogle Scholar

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© Springer-Verlag Italia 2015

Authors and Affiliations

  1. 1.Department of Surgery and Translational MedicineUniversity of FlorenceFlorenceItaly

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