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    Predictors of hypocalcemia in patients undergoing parathyroidectomy with the diagnosis of primary hyperparathyroidism
    (2020) Kuzu, Fatih; Ekici, Mehmet Fatih
    Objectives: Hypocalcemia is one of the important and potentially dangerous complications seen after parathyroid surgery. The purpose of our study was to determine the predictive factors for hypocalcemia in the postoperative period and to identify the risky patient group. Methods: 77 patients who underwent parathyroid surgery between January 2014 and July 2018 were included in the study. The patients were divided into four groups on the first postoperative day and on the fourth day in patients with hypocalcemia and normocalcemic cases. Factors predicting hypocalcemia were statistically compared between groups. Results: The mean age of the patients (F/M: 65/12) was 58.2±11.7 years. The preoperative serum calcium level of patients with hypocalcemia on the first postoperative day was <12.05 mg/dl. The preoperative cut-off values of parathormone >187.5 pg/ml, 25-hidroxy vitamine D (25 OHD) <10.5 ng/ml, phosphorus <2.45 mg/dl, and parathyroid adenoma volume >1.04 cm3 were present in patients with prolonged hypocalcemia on postoperative fourth day. Conclusion: In the preoperative period, determining the factors to predict postoperative hypocalcemia will reduce the complications due to severe hypocalcemia and shorten the hospitalization time.
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    Safe method for the treatment of primary hyperparathyroidism in geriatric patients: minimally ınvasive parathyroidectomy
    (DergiPark, 2020) Ekinci, Mehmet Fatih; Kuzu, Fatih; Zeren, Sezgin; Yildirim, Ali Cihat; Akdemir, Erhan; Onbasi, Kevser; Algin, Mustafa Cem
    Aim: Primary hyperparathyroidism is the most important cause of clinically hypercalcemia. Parathyroid adenomas are the most common endocrinology disorder in primary hyperparathyroidism. In this study, we aimed to evaluate the reliability of this surgery in patients older than 65 years by examining the data of patients who underwent parathyroidectomy for parathyroid adenoma. Material and Method: Patients were divided into two groups as those aged 65 years and over and adults. Age, gender, comorbidities, ASA score, preoperative and postoperative laboratory findings, imaging methods and operative times were reviewed. A p value of <0.05 was used for significance. Results: Ninety patients with parathyroid adenoma were included in the study. Female gender was dominant in both groups. The mean age was 52.15 } 8.87 in Group 1 and 71.39 } 5.76 in Group 2. When the associated co-morbidity was evaluated, no statistical difference was found between the two groups for diabetes mellitus and hypertension diseases. When the patients with nephrolithisis were evaluated, there were 21/64 (32%) kidney stones in group 1 and 6/26 (23%) kidney stones in group 2 and there was no statistical difference in both groups. Although the ASA score was higher in the geriatric group, there was no difference between the duration of surgery and length of hospital stay. There were no postoperative complications and morbidity. Conclusion: Adenoma surgery is an effective treatment method for primary hyperparathyroidism. Additional diseases and geriatric age period patients do not lead to an increase in surgical efficacy and complication rates. The surgeon procedure time was not prolonged despite the significant difference in ASA score in geriatric patients. Minimally invasive parathyroidectomy is a safe surgical procedure in geriatric patients. Our study as far as we know is the first in our literature about minimal invasive parathyroidectomy on geriatric patients.