A prospective study to determine the role of routine prophylactic oral calcium and vitamin D supplements in prevention of transient hypocalcaemia after total and near total thyroidectomy

Kiran Sukumaran Nair; Jose Gamalial; Rajesh P. S.

doi:10.18203/2349-2902.isj20175913

Authors

Kiran Sukumaran Nair Department of General Surgery, Government Medical College, Kottayam, Kerala, India
Jose Gamalial Department of General Surgery, Government Medical College, Kottayam, Kerala, India
Rajesh P. S. Department of General Surgery, Government Medical College, Kottayam, Kerala, India

DOI:

https://doi.org/10.18203/2349-2902.isj20175913

Keywords:

Calcium, Hypocalcaemia, Total or near total thyroidectomy, Vitamin D

Abstract

Background: Transient hypocalcaemia is a frequent complication after total thyroidectomy, and the symptoms are very distressing for the patients. This study is a prospective cohort study to assess the effectiveness of routine postoperative oral calcium and vitamin D supplementation in post thyroidectomy hypocalcaemia.

Methods: 135 patients undergoing near total or total thyroidectomy were divided into two groups, exposed and unexposed, based on post-operative calcium and Vitamin D administration. Both groups were followed up at day 3, at discharge and 2 weeks post operatively for the development of hypocalcaemia.

Results: Common age group was 31-40 years in both groups. The mean corrected pre-operative serum calcium was 9.06±0.43mg/dl for the exposed and 9.2±0.62mg/dl for the unexposed group (p = 0.12). The mean corrected calcium levels, on third post op day was 8.9±0.61mg/dl for exposed and 8.5±0.69mg/dl for unexposed group p = 0.001), on day of discharge was 9.2±0.56mg/dl for exposed and 9.0±0.48mg/dl for unexposed group (p = 0.019), and at 2 weeks follow-up was 9.5±0.51mg/dl for exposed and 9.2±0.63mg/dl for unexposed group (p = 0.002). Incidence of clinical symptoms of hypocalcaemia in the exposed group was 5.1% and in the unexposed group was 25.9%. Majority of these patients had transient hypo-calcaemic symptoms in the 48-72hr time period after surgery in both the groups.

Conclusions: Routine prophylactic oral calcium and Vitamin D supplementation is effective in preventing transient hypocalcaemia following total or near total thyroidectomy.

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