Abstract Background Hypocalcaemia is a common complication after thyroidectomy. Bariatric surgery is associated with significant changes in calcium metabolism. Some studies have identified bariatric surgery as a risk factor for hypocalcaemia after thyroidectomy. This systematic review and meta-analysis assessed whether a history of bariatric surgery was associated with an increased risk of hypocalcaemia after thyroidectomy. Methods This prospectively registered systematic review (PROSPERO; CRD42021295423) was performed in accordance with PRISMA guidelines. Meta-analysis was undertaken using the Mantel–Haenszel method, with outcomes reported as ORs with 95 per cent confidence intervals. Results Twenty studies were included in the qualitative synthesis. Five studies incorporating 19 547 patients met the inclusion criteria for meta-analysis, of whom 196 (1.0 per cent) had a history of bariatric surgery. Patients with a history of bariatric surgery were more likely to develop hypocalcaemia after thyroidectomy (30.6 versus 13.0 per cent; OR 3.90, 95 per cent c.i. 1.50 to 10.12; P = 0.005). Among those with a history of bariatric surgery, patients who underwent a bypass procedure were more likely to develop hypocalcaemia after thyroidectomy than those who had a restrictive procedure (38 versus 23 per cent; OR 2.12, 1.14 to 3.97; P = 0.020). Conclusion Patients with a history of bariatric surgery have a significantly greater risk of hypocalcaemia after thyroidectomy, with a heightened risk among those who have had a bypass procedure. Surgeons performing thyroid surgery should be aware of the increased risk of hypocalcaemia after thyroidectomy among these patients.

中文翻译：

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既往接受过减肥手术的患者甲状腺切除术后低钙血症：系统评价和荟萃分析

摘要 背景低钙血症是甲状腺切除术后常见的并发症。减肥手术与钙代谢的显着变化有关。一些研究已确定减肥手术是甲状腺切除术后低钙血症的危险因素。这项系统评价和荟萃分析评估了减肥手术史是否与甲状腺切除术后低钙血症风险增加相关。 方法这项前瞻性注册系统评价（PROSPERO；CRD42021295423）是根据 PRISMA 指南进行的。使用 Mantel-Haenszel 方法进行荟萃分析，结果以 OR 报告，置信区间为 95%。 结果定性综合中纳入了二十项研究。五项研究纳入了 19 547 名患者，符合荟萃分析的纳入标准，其中 196 名患者（1.0%）有减肥手术史。有减肥手术史的患者在甲状腺切除术后更容易出现低钙血症（30.6% vs 13.0%；OR 3.90，95% CI 1.50 至 10.12；P = 0.005）。在有减肥手术史的患者中，接受旁路手术的患者比接受限制性手术的患者更容易在甲状腺切除术后出现低钙血症（38% vs 23%；OR 2.12、1.14 至 3.97；P = 0.020）。 结论有减肥手术史的患者在甲状腺切除术后发生低钙血症的风险明显更高，而接受过搭桥手术的患者发生低钙血症的风险更高。进行甲状腺手术的外科医生应该意识到这些患者甲状腺切除术后低钙血症的风险增加。