Abstract
Background: Total thyroidectomy is a commonly performed surgery in our part of the country. Injury to parathyroids or total loss of the parathyroid glands is an important complication of total thyroidectomy which leads to transient or persistent hypocalcemia.
Aims: To find out the incidence of post thyroidectomy hypocalcemia in patients undergoing total thyroidectomy and to evaluate the risk of hypocalcemia following total thyroidectomy by early serial postoperative serum calcium level estimation.
Materials and Methods: After ethical committee approval and informed consent from patients a crosssectional study was performed in 60 patients undergoing total thyroidectomy within a period of 6 months. Postoperative serial calcium estimation in 12, 24, 72 hours and after 7 days was performed and results were analysed by entering in Microsoft excel.
Results: By analysing the data using appropriate software, three groups of patients showing positive trend, negative trend and doubtful trend in serum calcium status were obtained. In patients showing a positive trend in early serum calcium estimation showed no incidence of persistent hypocalcemia where as those with negative trend showed a considerable incidence of hypocalcemia.
Conclusion: In our study estimation of early serum calcium levels after total thyroidectomy
helped to identify patients with risk of developing persistent hypocalcemia and patients who can be discharged early without much hypocalcemic complications.
Keywords: Total thyroidectomy, hypocalcemia, serum calcium estimation, positive trend, negative trend.
References
- Incidence of Post-Operative Hypocalcaemia after Thyroidectomy: A Case Control Study Viswanathan KV1, Jithunath MR2 , Manjusha Viswanathan3
- Study of Complications of Thyroidectomy with Special Reference to Recurrent Laryngeal Nerve Injury. Sreejayan M. P.1, Arun S.2 , Rashmi Ravindran3 , Rafeek Ahmed4 1 Additional Professor, Department of General Surgery, Government Medical College, Kozhikode. 2 Assistant Professor, Department of General Surgery, Government Medical College Manjeri, Kerala, India. 3 Assistant Professor, Department of Anaesthesia, Government Medical College, Kozhikode, Kerala, India.
- Delbridge L, Guinea AI, Reeve TS. Total thyroidectomy for bilateral benign multinodulargoiter: effect of changing practice. Arch Surg 1999; 134: 1389-93.
- Clinical Study of Hypocalcemia following Thyroid Surgery Muthukumaraswamy, P (2008) Clinical Study of Hypocalcemia following Thyroid Surgery.Masters thesis, Tirunelveli Medical College, Tirunelveli
- Bron LP, O'Brien CJ. Total thyroidectomy for clinically benign disease of the thyroid gland. Br J Surg 2004; 91: 569-74.
- American association of clinical endocrinologists and american college of endocrinology disease state clinical review: postoperative hypoparathyroidism - definitions and managementbrendan c. Stack, jr., md, facs, face1; david n. Bimston, md, facs, fsso2; donald l. Bodenner, md, phd3; elise m. Brett, md, face, cnsc, ecnu4; henning dralle, frcs, facs, febs5; lisa a. Orloff, md, facs6; Johanna pallota, md, facp, face7; samuel k. Snyder, md,facs8; richardj. Wong, md9; gregory w. Randolph, md, facs, face, chair for the aace endocrine surgery scientific committee10
- Hypocalcaemia following total thyroidectomy: An analysis of 806 patientsC Gopalakrishnan Nair1, Misha J. C. Babu2, Riju Menon2, Pradeep Jacob2
- Monitoring of Hypocalcaemia & Hyperglycemia predictive consequences of Thyroidectomy Syed Wasif Gillani1*, Diana Laila Rahmatillah2 , YellyOktavia Sari1, Mirza R Baig3 and Syed Azhar Syed Sulaiman4
- Nahas ZS, Farrag TY, Lin FR, Belin RM, Tufano R. A safe and cost-effective short hospital stayprotocol to identify patients at low risk for the development of significant hypocalcemia aftertotal thyroidectomy. Laryngoscope.2006; 116(6): 906-910.
- AncuţaLeahu, Vanessa Carroni, G. Biliotti. Calcium level, A predictive factor of hypocalcemia following total thyroide-ctomy. Jurnalul de Chirurgie, Iaşi, 2009, Vol. 5, Nr. 2 [ISSN 1584 – 9341].
- Iqbal M, Subhan A, Baig M.S, Shah M.S. Frequency of hypocalcemia in total thyroidectomy. Journal of Surgery Pakistan (International) 15 (2) April - June 2010 p87-91.
- Kim Y.S. Impact of preserving the parathyroid glands on hypocalcemia after total thyroidectomy with neck dissection. J Korean Surg Soc. 2012 august 83(2): 75-82.
- Muller P.E, Kabbus S, Robens E, Spelsberg F. Indications,Risks, and Acceptance of Total Thyroidectomy for Multinodular benign goiter. Surg Today. Nov 2001, vol. 31, issue 11, p 958-62.
- Pisanu A, Saba A, Coghe F, Ucchedu A et al. Early prediction of hypocalcemia following total thyroidectomy using combined i-PTH and serum calcium measurement. Langenbecks Arch Surg. Oct 2012. Springer -Verlag Berlin Heidelberg 2012.
Corresponding Author
Dr Ramlal .R.V.
Mob: 9447037787, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i7.142
