Endocrine Abstracts

Goals

The most common complication of thyroidectomy is hypocalcaemia. The aim of this work is to determine the epidemiological, ethiopathogenic and therapeutic characteristics of hypocalcemia after total thyroidectomy.

Material and methods

This is a retrospective study of 27 cases of patients operated on for a total thyroidectomy complicated by hypocalcemia, over a period of 9 years (2009–2017) collected by ENT Farhat Hached Sousse.

Results

27 of 320 patients operated on for total thyroidectomy presented with postoperative hypocalcaemia (8%). The average age was 40.5 years [17–78 years], with a clear predominance of women (92.6%). Systematic preoperative serum calcium was correct in all cases. Calcium assay was systematic on D3 postoperatively. Hypocalcaemia was asymptomatic in 48% of cases. The clinical manifestations were observed on D1 postoperative in 3 patients and on D2 postoperatively in 11 patients. Paresthesia of the extremities was the most common symptom (85.7%). Muscle cramps were observed in 2 patients. No patient presented with a heart rhythm disturbance or an attack of tetany. The mean serum calcium was 1.67 mmol/l [1.4–1.9 mmol/l]. A parenteral, intravenous correction was necessary in 18 patients. Oral relay in combination with Vit D was initiated in all patients. The mean duration of treatment was 3.7 months [1–9 months]. The course was marked by regression of symptoms and biological correction in all cases.

Conclusion

Hypocalcaemia is a frequent complication of total thyroidectomy, which can be feared by its cardiac and respiratory complications that can be life-threatening, hence the importance of detecting it by systematic dosing after surgery. Understanding of ethiopathogenic mechanisms is necessary for correct management.