Postoperative hypoparathyroidism: relevance, prevention, treatment. Review

The aim of this article is to review the main aspects of postoperative hypoparathyroidism, causes and mechanisms of development, prevention, treatment, its results and consequences. Postoperative hypoparathyroidism is a frequent complication of operations on the thyroid gland. It reduces the quality of life of patients, and in some cases leads to disability and death. An analysis of the methods for preventing intraoperative injuries of the parathyroid glands, prevention of postoperative hypoparathyroidism and their assessment by various authors was carried out. Attention is drawn to the fact that uncontrolled drug therapy of postoperative hypoparathyroidism has several side effects that cause the development of complications in the functioning of organs and systems of the body: hearing, vision, cardiovascular, nervous and urinary systems, musculoskeletal system, gastrointestinal tract. Impaired quality of life, significantly impacting physical, mental, or emotional health, has been documented in many studies using standardized instruments validated for chronic illness. Therefore, the prevention and reduction of the permanent form of this complication is of particular importance and relevance. It should be noted that scientific interest in the problem of postoperative hypoparathyroidism is supported by the contradictory results of research by modern authors, especially regarding the prevention of the development of functional insufficiency of the parathyroid glands. Summarizing the considered publications devoted to postoperative hypoparathyroidism in thyroid surgery, it is worth emphasizing that the problem remains relevant and not fully resolved. The risks of postoperative hypoparathyroidism can be divided into factors related to the patient (polymorbidity, vitamin D deficiency, female gender, young age), as well as to the disease that became an indication for surgery (goiter, progressive malignant tumor, hyperthyroidism, autoimmune thyroiditis), and with surgical intervention (volume of surgical intervention, repeated operations, experience of the surgeon).