Abstract
INTRODUCTION: Post-surgical hypoparathyroidism (PoSH) is a complication of thyroidectomy, that is associated with poor quality of life, increased cost of care, and morbidity and mortality. The clinical and biochemical predictors of PoSH have been evaluated in previous studies. This study explores putative factors like the surgeon's experience, timing of surgery, and season's impact on PoSH. MATERIALS AND METHODS: A retrospective cohort study conducted in a high-volume centre. Patients who underwent total or completion thyroidectomy (TT/CT) performed by a single surgeon from January 2010 to December 2022 were included. Key outcomes were postoperative hypocalcaemia (adjusted serum calcium <2.1 mmol/L on the first postoperative day) and long-term PoSH (the need for calcium and/or alfacalcidol at six months after surgery). Demographics, and perioperative and postoperative clinical data relevant to PoSH up to six months were analysed. RESULTS: Of the 668 thyroid operations performed by the surgeon, 632 (94.6%) were included for analysis. The median age was 47.3 (18-87) years. TT was performed in 82.4% and CT in 17.6%. Central neck dissection (CND) was performed in 26.9%. Postoperative hypocalcaemia and long-term PoSH rates were 19.9% and 4.9%, respectively. CND significantly increased the rate of long-term PoSH (3.3% in TT vs. 9.2% in TT + CND; P = 0.02 and 1.7% in CT vs. 8.2% in CT + CND; P = 0.02). Increasing surgical experience, surrogate variables for surgeon fatigue, and seasons did not change the rate of PoSH significantly. CONCLUSION: The study confirmed CND as a risk factor for long-term PoSH but did not find surgeon experience, fatigue, and seasons to have an impact on the PoSH rate.