A Clinical Study and Management of Hypocalcemia Following Thyroid Surgery

Abstract

Background Post-thyroidectomy hypocalcaemia is a serious complication. Hypocalcaemia may occur secondarily to surgical trauma, devascularisation, unintentional removal of parathyroid glands, reoperation. Surgery has been seen as a risk factor, as in total thyroidectomy there is potential blood supply involvement resulting from bilateral surgical manipulation. This study aims to prospectively study and analyse the incidence and possible causes of hypocalcaemia following thyroid surgery, and its management. Method and Mateirals Data was collected from the patients undergoing subtotal and near total thyroidectomies from November 2012 to October 2014 by evaluating and investigating meticulous and planned for surgery. They were follow-up on day one after surgery, at the time of discharge and 6 months after surgery for post-operative hypocalcaemia. Observation 6 out of 50 patients (12%) developed postoperative hypocalcaemia, there was no incidence of permanent hypocalcaemia. Near total thyroidectomy was performed in 35(70%) patients, 1 from them (2.86%) developed hypocalcaemia and the other 5 out of 14 cases (35.71%) underwent total thyroidectomy. The hypocalcaemia was 9% in multinodular goitre (3 out of 33 patients), 20% in papillary carcinoma (1 out of 5 patients) and 40% in follicular neoplasm (2 out of 5 patients). Conclusion When preservation of parathyroid glands and their blood supply is enforced during thyroidectomy, the incidence of postoperative hypocalcaemia and permanent hypoparathyroidism can be consistently deceased.