Akademik Veri Yönetim Sistemi
12. Cerrahi Araştırma Kongresi, İstanbul, Türkiye, 14 - 16 Kasım 2025, cilt.41, sa.85, ss.40-41, (Özet Bildiri)
Objective: Minimally invasive parathyroidectomy (MIP) is a current surgical approach used in place of traditional neck exploration for the treatment of primary hyperparathyroidism (PHPT). Hypocalcemia following MIP can lead to a heterogeneous clinical picture. This study aimed to classify the clinical subtypes of hypocalcemia and identify risk factors for each. Furthermore, we aimed to introduce the definition of “suppressive hypoparathyroidism”, a new form of hypocalcemia characterized by postoperative PTH reduction but clinical asymptomatic status. Material and Methods: Patients with PHPT who underwent MIP and were diagnosed with adenomas preoperatively were evaluated retrospectively between November 2020 and December 2024. Demographic characteristics, biochemical parameters, bone mineral density, adenoma weight, and postoperative hypocalcemia findings were compared. Patients were grouped according to the development of “suppressive hypoparathyroidism” and “hungry bone syndrome (HBS)”. Results and Conclusion: One hundred twenty-six patients were evaluated. Preoperative serum calcium level (p=0.007), phosphorus level (p<0.001) and femoral neck T-scores were significantly higher (p=0.03) in patients who developed suppressive hypoparathyroidism. Multivariate analysis revealed that low phosphorus level [odds ratio (OR): 0.21; 95% confidence interval (CI): 0.05-0.85; p=0.029] and high femoral T-score (OR: 2.10; 95% CI: 1.22-3.62; p=0.008) were independent risk factors for suppressive hypoparathyroidism. In patients who developed HBS, preoperative PTH (p<0.001), ALP levels (p=0.01) and adenoma weight (p=0.03) were higher and femoral T-scores were lower (p=0.02). Only a high preoperative PTH level was a significant independent predictor of HBS development (OR: 1.006; 95% CI: 1.00-1.01; p=0.009). Hypocalcemia after MIP cannot be considered a single clinical entity. Suppressive hypoparathyroidism, as defined in this study, is a specific subcategory for patients with postoperative PTH decrease but who are clinically mildly symptomatic or asymptomatic. HBS, on the other hand, is characterized by more aggressive biochemical abnormalities. Differentiating these two conditions may facilitate postoperative management and patient follow-up.
Keywords: Minimally invasive parathyroidectomy, primary hyperparathyroidism, suppressive hypoparathyroidism