Study of incidence of hypocalcaemia in patients undergoing total thyroidectomy for papillary carcinoma: a retrospective study

Authors

  • S. P. Gayathre Institute of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India
  • R. Niranjan Kumar Institute of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India
  • M. J. Prabu Institute of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India http://orcid.org/0000-0001-9286-4997

DOI:

https://doi.org/10.18203/2349-2902.isj20213607

Keywords:

Hypocalcemia, Incidence, Total thyroidectomy

Abstract

Background: Hypocalcaemia following total thyroidectomy is a fairly common complication. Occurrence of acute hypocalcaemia can be predicted in patients undergoing thyroid surgery for malignancy, based on serial calcium measurement and this helps in early prediction of hypocalcaemia. The aim of the study was to assess the incidence of post thyroidectomy hypocalcaemia and methods to treat hypocalcaemia and prevention of its complication at the earliest.

Methods: The incidence of hypocalcemia was analysed with serial calcium estimation in immediate post-operative period, 4 hours and 24 hours after surgery and on 5th post-operative day. The factors analysed included pre-operative and post-operative serum calcium levels, clinical features, the disease type and factors related to surgery and histopathologically diagnosis as malignant papillary thyroid carcinoma is confirmed.

Results: In this study 30 patients underwent total thyroidectomy for papillary carcinoma were studied. Incidence of 22% of hypocalcemia, with transient hypocalcemia in 20% and permanent hypocalcemia in 2% of cases were noted.  

Conclusions: Patients underwent thyroid surgery for malignant conditions showed higher incidence and severity hypocalcaemia. This complication can be prevented with meticulous peroperative dissection, prompt identification of parathyroid gland. Avoiding injury or spasm of the blood vessels supplying them and frequent postoperative monitoring of serum calcium levels. 

References

Baldassarre RL, Chang DC, Brumund KT, Bouvet M. Predictors of hypocalcemia after thyroidectomy: results from the nationwide inpatient sample. ISRN Surg. 2012;838614.

Bellantone R, Lombardi CP, Raffaelli M, Boscherini M, Alesina PF, Crea C, et al. Is routine supplementation therapy (calcium and vitamin D) useful after total thyroidectomy? Surgery. 2002;132(6):1109-12.

Roh JL, Park CI. Routine oral calcium and vitamin D supplements for prevention of hypocalcemia after total thyroidectomy. Am J Surg. 2006;192(5):675-8.

Abboud B, Sargi Z, Akkam M, Sleilaty F. Risk factors for postthyroidectomy hypocalcemia. J Am Coll Surg. 2002;195(4):456-61.

Thomusch O, Machens A, Sekulla C, Ukkat J, Lippert H, Gastinger I, Dralle H. Multivariate analysis of risk factors for postoperative complications in benign goiter surgery: prospective multicenter study in Germany. World J Surg. 2000;24(11):1335-41.

Henry CR, Speroff T, Wentworth D, Murphy T. Risk factors for postthyroidectomy hypocalcemia. Surgery. 1994;116(4):641-7.

Baldassarre RL, Chang DC, Brumund KT, Bouvet M. Predictors of hypocalcemia after thyroidectomy: results from the nationwide inpatient sample. ISRN Surg. 2012;838614.

Zakaria HM, Awad NA, Kreedes AS, Mulhim AM, Sharway MA, Hadi MA, et al. Recurrent laryngeal nerve injury in thyroid surgery. Oman Med J. 2011;26(1):34-8.

Eismontas V, Slepavicius A, Janusonis V, Zeromskas P, Beisa V, Strupas K, et al. Predictors of postoperative hypocalcemia occurring after a total thyroidectomy: results of prospective multicenter study. BMC Surg. 2018;18(1):55.

Thomusch O, Machens A, Sekulla C, Ukkat J, Brauckhoff M, Dralle H. The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surgery. 2003;133:180-5.

Arumugam S, Mohankumar A, Muthukumaraswamy A, Anandan H. Clinical study of hypocalcemia following thyroid surgery. Int J Sci Stud. 2017;4:37-41.

Downloads

Published

2021-08-27

Issue

Section

Original Research Articles