To investigate the influencing factors and prevention strategies of hypoparathyroidism after endoscopic thyroidectomy.

The perioperative and postoperative data of 135 patients with thyroid diseases treated by endoscopic surgery in Zhujiang Hospital, Southern Medical University from January 2021 to January 2022 were retrospectively reviewed. The trends of serum calcium and parathyroid hormone (PTH) before operation and 1 month after operation were analyzed, and the influencing factors of hypoparathyroidism were analyzed by multivariate Logistic regression analysis.

Among the 135 patients, 93 were non-hypothyroidism (group A) and 42 were hypothyroidism, 15 of them were biochemical hypothyroidism (group B) and 27 were clinical hypothyroidism (group C). Among the 42 patients with hypothyroidism, 39 patients had temporary hypothyroidism and 3 patients had permanent hypothyroidism. The decrease of PTH and serum calcium concentration in group A was 35% and 4%; 63% and 10% in Group B; 85% and 19% in Group C, and the differences were statistically significant (F=90.57, 84.77; both P<0.001). Compared with the first day after operation, results on 1 month after operation PTH and blood calcium concentration levels were recovered to a certain extent. Compared with preoperative results, PTH was decreased by 9%, 21%, 44% in group A, group B, group C, respectively, and blood calcium concentration increased by 6% in group A, 4% in group B and decreased by 4% in group C, with statistically significant differences (F=9.99, 4.38; P<0.001, 0.017). Multivariate Logistic regression analysis found that thyroidectomy scope (OR=27.53, 95% CI: 7.74-97.93, P<0.001), lymph node dissection (OR=5.87, 95% CI: 1.15-29.89, P=0.033) were risk factors for hypoparathyroidism after endoscopic thyroidectomy.

Thyroidectomy scope and lymph node dissection are the influencing factors of hypoparathyroidism. The function of parathyroid is still needed for the assessment 1 month after surgery.