Role of prophylactic postoperative calcium supplementation following total thyroidectomy in preventing hypocalcemia

Abstract

ABSTRACT

Background:Hypocalcemia remains a major post-operative complication of total thyroidectomy causing potentially serious side effects and tension in influenced patients and expanding hospitalization time. Accurate prediction and appropriate management may help reduce morbidity and hospital stay.

Aim of study: To evaluate the effect of Ca supplementation following thyroidectomy in preventing hypocalcemia.

Patients and Methods: A randomized prospective study including 74 patients who underwent total thyroidectomyin the surgical unit, Department of Surgery, Al-Khidhir Hospital in Al-Muthanna provinceduring a period of two years and six months from Oct, 2015 – April, 2018. Group A - patients who didn’t receive any supplement (37 patients), group B - patients who received Ca therapy immediately after operation (37 patients). Laboratory tests for S.Ca were done preoperatively and postoperatively at day 0, day one, day two, day three, and then after 10 days and for patient who developed hypocalcaemia, another reading was done after 10 – 20 days and followed monthly.

Results: No significant differences (P ≥ 0.05) between study groups regarding age, BMI and duration of goiter. At day zero and day one postoperatively, no significant association between prevalence of hypocalcemia and receiving Ca postoperatively (P≥0.05) while at day two and three, this association was significant and hypocalcemia occurred more prevalent in patient of group A. Patients of group B were discharged earlier than patients of group A (58.9% versus 41.1%).

Conclusion: Routine Ca supplementation following total thyroidectomy is better than no supplement. Although they do not completely eliminate the occurrence of postoperative hypocalcemia.

Keywords: Thyroidectomy, calcium, Muthanna, Iraq, hypocalcemia