Endocrine Abstracts

Thyroid surgery is a frequent procedure that has certain risks. After a complete thyroidectomy, hypocalcemia is the most prevalent consequence. It has a variety of causes, with hypoparathyroidism being the most frequent and dangerous.

Materials and procedures: A retrospective analysis collected 27 cases of patients who had a total thyroidectomy complicated by hypocalcemia among 320 patients who underwent a total thyroidectomy throughout the study period, which spanned nine years (2010–2020). The goal of our research is to identify the characteristics that predict post-total thyroidectomy hypocalcemia, as well as the consequences and various therapy options.

Results: The average age of the participants was 40.5 years [17–78 years]. Females made up 92.6 percent of the patients. On D3, postoperatively, a systematic assessment of serum calcium was performed. In terms of clinical symptoms, 48% of individuals were asymptomatic. On D1 surgical day, 3 patients had symptomatic hypocalcaemia, and on D2 postoperative day, 11 patients had symptomatic hypocalcaemia. In addition, all of the patients’ preoperative serum calcium levels were normal. Apart from surgical devascularization of the parathyroid glands, 23 individuals had postoperative hypocalcemia. The primary symptom in symptomatic individuals was paresthesias of the extremities (85.7 percent). In two of the patients, muscle cramps were noted. There were no cardiac arrhythmias or tetany crises in any of the individuals. The mean serum calcium concentration was 1.67 mmol/l (range: 1.4 to 1.9 mmol/l). In 18 individuals, intra-hospital parenteral correction with calcium gluconate was required. On discharge, all patients were given calcium supplements along with vitamin D. The average treatment time was 3.7 months [1–9 months]. In 25 cases, the result was positive (correction of hypocalcaemia). Two patients were misplaced.

Conclusion: Hypocalcemia following thyroid surgery can be severe, but it’s usually reversible. The first step in prevention is to carefully dissect the parathyroid glands and preserve their circulation. Despite this, a low preoperative vitamin D level predicts the development of postoperative hypoparathyroidism, which might be asymptomatic prior to surgery. Other prospective trials are needed to clarify the interest in a possible preoperative vitamin D supplementation as well as the mode of supplementation.