Endocrine Abstracts

Background: Postsurgical hypocalcemia is the most common and most troubling long-term consequence of thyroidectomy. In this study, we investigated the potential role of routine calcium or vitamin D supplementation in preventing postsurgical hypoparathyroidism.

Methods: We carried out a systematic search of MEDLINE and EMBASE for English-language publications using the keywords “calcium”, “vitamin D”, and “thyroid cancer”. The primary outcome was any postoperative hypocalcemia, and the secondary outcome was symptomatic hypocalcemia. We analyzed data from the studies using Review Manager (RevMan, Version 5.2, Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2012).

Results: Four studies that included 381 patients were eligible for this meta-analysis. The random-effects model showed no significant difference in the occurrence of hypocalcemia between calcium/vitamin D treatment and placebo/no treatment (OR 0.82, 95% CI 0.36–1.86, P = 0.63). The occurrence of symptomatic hypocalcemia was lower in patients with calcium/vitamin D treatment than in those with placebo/no treatment (OR 0.44, 95% CI 0.22–0.88, P = 0.02). In combined results, we found that preoperative calcium and calcitriol supplementation, in addition to routine postsurgical supplementation, was associated with a reduced incidence of symptomatic hypocalcemia after total thyroidectomy.

Conclusion: This study supports the use of preoperative calcium and vitamin D supplementation in conjunction with routine postsurgical supplementation for patients undergoing total thyroidectomy.