Endocrine Abstracts

Objective: Identify the risk factors of hypoparathyroidism (hypoPT) after Total thyroidectomy (TT).

Patients and Methods: Our study is a randomised clinical trial. It enrolled patients who underwent total thyroidectomy at the department of ENT surgery at Habib Bourguiba Hospital in Sfax between November 2020 and august 2021. We studied age, gender, type of surgery, duration of surgery, vitamin D level, magnesium level, histopathological exam, inadvertent resection of parathyroid gland, central neck dissection (CND) and the impact of prophylactic supplementation with oral calcium and vitamin D.

Results: Forty-seven patients were recruited for this study. They were divided into two groups: group 1: with prophylactic supplementation (24 patients) and group 2: without prophylactic supplementation (23 patients). We studied the impact of the risk factors on day one parathormone level. There were 19 patients with transient postoperative hypoparathyroidism. There was not a significant difference between the two groups regarding Day 1 PTH level. The results of univariate analysis showed a significant relation between transient hypoPT with severe hypovitaminosis D (P=0.001), operative time(P=0.01), CND (P=0.03) and accidental resection of parathyroid gland (P=0.04). Multivariate analysis did not show any relation of hypoPT with any risk factor. The prophylactic supplementation allowed to significantly reduce the occurrence of biological and clinical hypocalcaemia.

Conclusion: In multivariate logistic regression we did not identify any independent risk factor. This explains the difficulty to predict the occurrence of such a complication. For that, prophylactic postoperative supplementation with oral calcium and vitamin D seems to be a safe choice to prevent postoperative hypocalcaemia.