Betamethasone to Prevent Symptomatic Hypocalcaemia and Other Complications after Total Thyroidectomy: a Case-control Study

Picchio Marcello; Di Filippo Annalisa Romina; Spaziani Martina; Orelli Simone; Bellagamba Riccardo; Guttoriello Giuliano; De Cesare Alessandro; Spaziani Erasmo

doi:10.16956/jes.2021.21.3.61

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저자정보: Picchio Marcello (Department of Surgery Hospital “P. Colombo” Velletri Italy.) Di Filippo Annalisa Romina (Department of Medico-Surgical Sciences and Biotechnologies Sapienza University of Rome Polo Pontino) Spaziani Martina (Department of Medico-Surgical Sciences and Biotechnologies Sapienza University of Rome Polo Pontino) Orelli Simone (Department of Radiological Oncological and Anatomo-Pathological Sciences Sapienza University of Rom) Bellagamba Riccardo (Department of Surgery Hospital “P. Colombo” Velletri Italy.) Guttoriello Giuliano (Department of Medico-Surgical Sciences and Biotechnologies Sapienza University of Rome Polo Pontino) De Cesare Alessandro (Department of Surgery “Pietro Valdoni” Sapienza University of Rome Rome Italy.) Spaziani Erasmo (Department of Medico-Surgical Sciences and Biotechnologies Sapienza University of Rome Polo Pontino)

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제21권 제3호

발행연도: 2021.9

수록면: 61 - 69 (9page)

DOI: 10.16956/jes.2021.21.3.61

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Purpose: The study aims to determine whether postoperative infusion of betamethasone reduces the risk of symptomatic hypocalcaemia (SHC) and other complications after total thyroidectomy. Methods: We compared a group of patients receiving betamethasone (beta group) postoperatively to a group without any perioperative glucocorticoid infusion (no beta group). Plasma levels of parathyroid hormone, total calcium, and C-reactive protein (CRP) were measured pre- and postoperatively. Complications were recorded within a 30-day follow-up. Postoperative SHC was the primary outcome. Results: In the beta group and the no beta group, 54 patients and 47 patients were included, respectively. In the beta group, the incidence of SHC (4 pts vs. 14 pts in the no beta group; P=0.003) was reduced. In the beta group, serum calcium levels were higher on postoperative day 1 (8.6 mg/dL vs. 8.2 mg/dL in the no beta group; P=0.001) and day 2 (8.7 mg/dL vs. 8.1 mg/dL in the no beta group; P<0.000). In the beta group, serum C-reactive protein levels were lower postoperatively. In a univariate analysis, American Society of Anaesthesiology score > I (odds ratio [OR], 0.19; P=0.002), no betamethasone treatment (OR, 0.19; P=0.006), and parathyroid glands remaining in situ (PGRIS) score <3 (OR, 6.00; P=0.005) were related to postoperative SHC; in a multivariate analysis, betamethasone treatment (OR, 0.09; P=0.007) and PGRIS score <3 (OR, 8.41; P=0.045) were related to postoperative SHC. No difference was observed in postoperative complications. Conclusion: Postoperative use of betamethasone reduces the incidence of SHC after thyroid surgery without affecting other complications.

#Thyroidectomy #Complications #Hypocalcemia #Betamethasone

참고문헌 (30)

참고문헌 신청

Edafe O / 2014 / Systematic review and meta-analysis of predictors of post-thyroidectomy hypocalcaemia / Br J Surg 101:307~320

Bhattacharyya N / 2002 / Assessment of the morbidity and complications of total thyroidectomy / Arch Otolaryngol Head Neck Surg 128:389~392

Reeve T / 2000 / Complications of thyroid surgery : how to avoid them, how to manage them, and observations on their possible effect on the whole patient / World J Surg 24:971~975

Holte K / 2002 / Perioperative single-dose glucocorticoid administration : pathophysiologic effects and clinical implications / J Am Coll Surg 195:694~712

Kolahdouzan M / 2019 / Preventive effect of dexamethasone therapy on the transient hypoparathyroidism through total thyroidectomy / Iran J Otorhinolaryngol 31:73~80

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