Hypoparathyroidism following total laryngopharyngectomy and gastric pull-up

Yosef P. Krespi, Carl F. Wurster, Tom Wang, David M. Stone

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Wc have used the gastric pull-up technique for closure of large pharyngocsophagcal defects after radical oncological surgery since 1979). The management of severe hypocalcemia and hypovitaminosis D seemed more difficult in puticnts undergoing pull-up reconstruction than in patients undergoing the same extirpative surgery, but reconstructed with more traditional methods. To determine if hypocalcemia and hypovitaminosis D were more common in gastric pull-up patients, and if postoperative management of these conditions is more problematic in this group, we retrospectively compared three groups of head and neck surgery patients. Group 1 consisted of 17 patients undergoing total laryngectomy with thyroid complex preservation. Group 2 consisted of 7 patients undergoing mediastinal dissection with total laryngectomy-thyroidectomy previously or concurrently. Group 3 consisted of 30 patients undergoing total laryngopharyngocsophngectomy-thyroidectomy and gastric pull-up reconstruction. The incidences of hypocalcemia requiring therapy were 12%, 50%, and 73%, respectively, with an overall incidence of 51%. The average amounts of supplemental calcium and vitamin D in the three groups were compared. A significant difference between the three groups was noted. Finally, the dietary calcium and vitamin D requirements for one problematic patient were prospectively recorded and summarized graphically. We conclude that any patient should be carefully monitored for the signs and symptoms of hypocalcemia after major head and neck surgery. In the special instance of the gastric pull-up patient, calcium requirements and the range of serum calcium fluctuation are greatly increased compared to patients undergoing more traditional methods of reconstruction.

Original languageEnglish (US)
Pages (from-to)1184-1187
Number of pages4
JournalLaryngoscope
Volume95
Issue number10
StatePublished - 1985
Externally publishedYes

Fingerprint

Hypoparathyroidism
Stomach
Hypocalcemia
Laryngectomy
Thyroidectomy
Calcium
Vitamin D
Neck
Head
Dietary Calcium
Incidence
Signs and Symptoms
Dissection
Thyroid Gland

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Krespi, Y. P., Wurster, C. F., Wang, T., & Stone, D. M. (1985). Hypoparathyroidism following total laryngopharyngectomy and gastric pull-up. Laryngoscope, 95(10), 1184-1187.

Hypoparathyroidism following total laryngopharyngectomy and gastric pull-up. / Krespi, Yosef P.; Wurster, Carl F.; Wang, Tom; Stone, David M.

In: Laryngoscope, Vol. 95, No. 10, 1985, p. 1184-1187.

Research output: Contribution to journalArticle

Krespi, YP, Wurster, CF, Wang, T & Stone, DM 1985, 'Hypoparathyroidism following total laryngopharyngectomy and gastric pull-up', Laryngoscope, vol. 95, no. 10, pp. 1184-1187.
Krespi, Yosef P. ; Wurster, Carl F. ; Wang, Tom ; Stone, David M. / Hypoparathyroidism following total laryngopharyngectomy and gastric pull-up. In: Laryngoscope. 1985 ; Vol. 95, No. 10. pp. 1184-1187.
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