Endocrine Abstracts

Introduction: Hypocalcemia is a well-known complication of total thyroidectomy. Usually, it’s a reversible and a transitory complication. However, it requires a regular check-up.

Objective: The aim of this study is to determine the epidemiological and the therapeutic characteristics of hypocalcemia after total thyroidectomy.

Methods: This is a retrospective study about 106 cases of total thyroidectomy that operated between the year of 2010 and 2019 in the ENT department in Kairouan.

Results: The average age was 44.11 [22–76 years] with a sex ratio of 0.1. The determination of serum calcium is done systematically at day 2 or 3 after surgery; earlier on if the hypocalcemia was symptomatic.The incident usually occurs 3 days after surgery. Postoperative hypocalcemia was found in 36 patients (33.9%). Symptoms were found in 20 patients (55.5%): 18 of them presented with paresthesia of the extremities (90%). And the other 2 patients presented with tetany (10%). All patients presented with hypocalcemia were given calcium gluconate and vitamin D orally. The IV supplementation was only given in 22.2% of the symptomatic patients.The treatment took about 2 months on average. And only 6 patients developed definitive hypocalcemia. The multinodular goiter was the most found pathology in the cases of postoperative hypocalcemia (72%). In second place comes the Grave’s disease (16%). And in third place, cancer. In our study, 6 patients had total thyroidectomy with lymph node dissection. 4 of them, developed postoperative hypocalcemia.

Conclusion: Hypocalcemia is a frequent complication of total thyroidectomy, needing both, clinical and biological surveillance. Temporary oral supplementation usually does the trick.