Endocrine Abstracts

Introduction: hyperparathyroidism is an endocrinopathy affecting calcium metabolism. Its curative treatment is surgical. Postoperative hypocalcemia is one of the main risks of this surgery.

Objective: The aim of this study is to identify predictive factors of postoperative hypocalcemia after surgery for primary hyperparathyroidism.

Method: This is a retrospective study including 84 patients operated on for pimary hyperparathyroidism in our department over a period from 2015 to 2023. We performed a statistical study in order to identify predictive factors of postoperative hypocalcemia.

Results: Early hypocalcemia (<4 days from surgery) was noted in 18 cases. It was related to hypoparathyroidism in 2 cases and to Hungry bone syndrome in 3 cases. Hypocalcemia was severe, leading to tetany in 3 cases. Predictive factors of early postoperative hypocalcemia were: the nature of the approach (unilateral or bilateral), association with a thyroid surgery, preoperative vitamin D deficiency and postoperative hypoparathyroidism (after 24 hours). Predictors of prolonged hypocalcemia (> 2 months) were: preoperative vitamin D deficiency, removal of a healthy gland in addition to the adenoma, preoperative malignant hypercalcemia, advanced bone disease, postoperative hypoparathyroidism and bulky adenomas.

Conclusion: Postoperative hypocalcemia is conditioned by certain clinical and biological factors. Demonstrating the involvement of these factors allows selecting at-risk patients in order to act on these parameters preoperatively, and to ensure stricter monitoring of the at-risk population postoperatively.