A retrospective study on the incidence of hypocalcemia and number of parathyroid glands identified and preserved during thyroid surgeries

Authors

  • Pauly T. J. Department of Surgery, Government Medical College M. G. Kavu, Thrissur, Kerala 680596, India
  • Santhosh P. V. Department of Surgery, Government Medical College M. G. Kavu, Thrissur, Kerala 680596, India
  • Santhosh T. V. Department of Surgery, Government Medical College M. G. Kavu, Thrissur, Kerala 680596, India
  • Vinodh M. Department of Surgery, Government Medical College M. G. Kavu, Thrissur, Kerala 680596, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20163778

Keywords:

Hypocalcaemia, Parathyroid glands, Thyroidectomy

Abstract

Background: Hypocalcaemia remains a major post-operative complication of total thyroidectomy causing potentially severe symptoms and anxiety in affected patients and increasing hospitalization time. Therefore the present study was designed to evaluate the incidence of hypocalcaemia and the number of parathyroid gland.

Methods: 146 patients who underwent total/near total thyroidectomy were recruited. The incidence of hypocalcaemia was analyzed with serial calcium estimation results with 6 hours, 24 hours, 48 hours and 2weeks post-operative calcium level estimations. The incidence of hypocalcaemia with regards to the number of parathyroid glands was determined and the results between the three groups were compared.

Results: The overall incidence of hypocalcaemia decreases with increase in the number of parathyroid glands per operatively. In Group-3, 16% of patients had hypocalcaemia in first 6 hours and 96% of patients had calcium value more than 8 mg/dl after 2 weeks without the features of hypocalcaemia. It was 84% and 77% in Group-1, 33% and 23% in Group-2.The difference was found to be statistically significant (p<0.001).

Conclusions: The incidence of hypocalcaemia decreases with increase in the number of parathyroid glands peroperativly in thyroid surgeries. The post-operative hypocalcaemia is predictable with the number of parathyroid glands and it gives a platform for an early discharge of the thyroidectomy patients without the fear of post-operative hypocalcaemia.

References

Bentrem DJ, Rademaker A, Angelos P. Evaluation of serum calcium levels in predicting hypoparathyroidism after total/ near-total thyroidectomy or parathyroidectomy. Am Surg. 2001;67:249-51.

Abboud B, Sargi Z, Akkam M, Sleilaty F. Risk factors for post thyroidectomy hypocalcemia. J Am Surg. 2002;195:456-61.

Lindblom P, Westerdahl J, Bergenfelz A. Low parathyroid hormone levels after thyroid surgery: a feasible predictor of hypocalcemia. Surgery. 2002;131:515-20.

Husein M, Hier MP, Al-Abdulhadi K, Black M. Predicting calcium status post thyroidectomy with early calcium levels. Otolaryngol Head Neck Surg. 2002;127:289-93.

Luu Q, Andersen PE, Adams J, Wax MK, Cohen JI. The predictive value of perioperative calcium levels after thyroid/parathyroid surgery. Head Neck. 2002;24:63-7.

Bellantone R1, Lombardi CP, Raffaelli M, Boscherini M, Alesina PF, De Crea C, et al. Is routine supplementation therapy (calcium and vitamin D) useful after total thyroidectomy? Surgery. 2002;132:1109-12.

Lombardi CP, Raffaelli M, Princi P, Santini S, Boscherini M, De Crea C, et al. Early prediction of post thyroidectomy hypocalcemia by one single iPTH measurement. Surgery. 2004;136:1236-41.

Del Rio P, Arcuri MF, Ferreri G, Sommaruga L, Sianesi M. The utility of serum PTH assessment 24 hours after total thyroidectomy. Otolaryngol Head Neck Surg. 2005;32:584-6.

Roh JL, Park CI. Intraoperative parathyroid hormone assay for management of patients undergoing total thyroidectomy. Head Neck. 2006;28:990-7.

Nahas ZS, Farrag TY, Lin FR, Belin RM, Tufano RP. A safe and cost-effective short hospital stays protocol to identify patients at low risk for the development of significant hypocalcemia after total thyroidectomy. Laryngoscope. 2006;116:906-10.

Rix TE, Sinha P. Inadvertent parathyroid excision during thyroid surgery. Surgeon. 2006;4:339-42.

McLeod IK1, Arciero C, Noordzij JP, Stojadinovic A, Peoples G, Melder PC, et al. The use of rapid parathyroid hormone assay in predicting postoperative hypocalcemia after total or completion thyroidectomy. Thyroid. 2006;16:259-65.

Asari R, Passler C, Kaczirek K, Scheuba C, Niederle B. Hypoparathyroidism after total thyroidectomy: a prospective study. Arch Surg. 2008;143:132-7.

Godlewska P, Kaniewski M, Stachlewska-Nasfeter E, Bisz D, Łyczek J. Parathyroid hypofunction after total thyroidectomy for differentiated thyroid carcinoma-perspectives after long term observation and treatment. Wiad Lek. 2001;54(Suppl 1):S398-404.

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Published

2016-12-19

How to Cite

J., P. T., V., S. P., V., S. T., & M., V. (2016). A retrospective study on the incidence of hypocalcemia and number of parathyroid glands identified and preserved during thyroid surgeries. International Journal of Research in Medical Sciences, 4(11), 4848–4851. https://doi.org/10.18203/2320-6012.ijrms20163778

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Original Research Articles