Hypocalcaemia After Total Thyroidectomy: Incidence, Control and Treatment

González‐Botas, Jesús Herranz; Piedrahita, Diana Lourido

doi:10.1016/j.otoeng.2012.09.009

Cited by 17 publications

(13 citation statements)

References 21 publications

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“…Factors contributing to this may be more chances of fibrosis & compromised vascularity to parathyroid glands in a previously operated neck as well as unknown functional status of the parathyroid glands on the previously operated side. But this is in contrary to the findings of González-Botas and Piedrahita 42 and Merchavy et al, 43 who reported that postoperative hypocalcaemia was less common in patients with completion thyroidectomy than in patients who underwent total thyroidectomy. However, other authors like Godlewska P, et al reported incidence of hypoparathyroidism to be 15.74% following radical thyroid surgery versus 23.43% after completion thyroidectomy, supporting the data obtained in the current study.…”

Section: Discussioncontrasting

confidence: 66%

Factors Contributing to Post-Operative Hypocalcaemia After Total Thyroidectomyexperience in a Tertiary Care Govt. Hospital in Eastern India

Basak¹,

Choudhary²,

Roy³

et al. 2019

jemds

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BACKGROUND Postoperative hypocalcaemia is a common complication after total thyroidectomy but most often it is transient. Although these are mostly amenable to calcium and vitamin D supplementation, symptomatic patients sometimes need prolonged hospitalization following thyroid surgery, leading to increased healthcare costs. In the present study, we tried to find out factors which can predict the occurrence of post-operative hypocalcaemia & hypoparathyroidism in total thyroidectomy patients, facilitating their early detection and institution of definitive management in time, preventing emergency admissions & catastrophes. METHODS A prospective observational study was carried out in the Department of ENT & Head-Neck Surgery of a tertiary care govt. hospital in eastern India. Patients who underwent total thyroidectomy for multinodular goitre (MNG) and adenomatoid goitre (AG) or total/completion thyroidectomy for well differentiated thyroid carcinomas (WDTC), in the age group of 20-55 years were included in our study. We recorded the following parameters: Age, gender distribution of cases, type of operation, pre-operative Fine Needle Aspiration Cytology (FNAC) status, size of thyroid nodule operated (based on pre-operative ultrasonographic study), number of parathyroid glands preserved during operation, pre-operative vitamin D levels, post-operative serum calcium levels at 6 hours & 12 hours (positive i.e. increasing slope & non-positive i.e. decreasing/non-changing slope), early post-operative serum iPTH levels (at 6 hours), development of symptomatic hypocalcaemia-transient or permanent. RESULTS In the present study we measured serum calcium level 6 hours & 12 hours post-operatively. It has been found that patients with serum calcium levels on positive slope have lesser chances of occurrence of symptomatic hypocalcaemia & permanent hypocalcaemia than those on non-positive slope. We found that patients having serum iPTH level between 15-65 pg/ml showed lesser propensity to develop hypocalcaemia in comparison with those with serum iPTH level <15 pg/ml. In our study, it has been found that all the 3 cases who developed permanent hypocalcaemia were suffering from vitamin D deficiency; whereas, patients with normal vitamin D levels posed lesser risk of developing significant hypocalcaemia. In our observation, patients with only two parathyroid glands identified per-operatively have more chances of developing hypocalcaemia & those in whom all four parathyroid glands were preserved, very low risk of hypocalcaemia is associated. Furthermore, preservation of functional parathyroid gland with intact blood supply is found to be of immense importance than mere identification of the glands. In our series, it has been noted that with increase in the size of thyroid nodule, chances of hypocalcaemia increases. Patients undergoing complete thyroidectomy for histopathological report of WDTC in a previously benign (based on pre-operative FNAC) thyroid nodule, increased chances of development of post-operative hypocalcaemia. CONCLUSI...

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Section: Discussioncontrasting

confidence: 66%

Factors Contributing to Post-Operative Hypocalcaemia After Total Thyroidectomyexperience in a Tertiary Care Govt. Hospital in Eastern India

Basak¹,

Choudhary²,

Roy³

et al. 2019

jemds

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“…Temporary hypocalcemia and permanent hypoparathyroidism have been reported in 5.4-29.1% and 0.5-4.7% of patients who have undergone total thyroidectomy, respectively [3,7,15,16]. Higher rates of permanent hypoparathyroidism have been reported in patients who have undergone total thyroidectomy in combination with central compartment neck dissection [11,17] and reoperative thyroidectomy [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…As with any operation, challenges include minimizing complications. The major complications of thyroidectomy include recurrent laryngeal nerve injury (1.2-7.6%) [2][3][4], bleeding requiring reoperation (0.6-1.6%) [2,3,5,6] and permanent hypoparathyroidism (1.2-5.5%) [2,[7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Inadvertent parathyroidectomy: incidence, risk factors, and outcomes

Zhou

McHenry

2016

Journal of Surgical Research

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“…Serum calcium levels 24 hours after surgery is not considered a very reliable predictor for the need of calcium therapy at discharge (13). The assessment of serum calcium begins to have clinical significance and starts to be predictive of a safe discharge only at 48 hours after surgery (13)(14)(15). This value, when altered, seems to be associated with symptomatic hypocalcaemia and the need for postdischarge therapy (15).…”

Section: Discussionmentioning

confidence: 99%