HYPOCALCEMIA IN TOTAL VERSUS SUBTOTAL THYROIDECTOMY

Tahira Sajid, Syeda Rifaat Qamar Naqvi, Zara Sajid, Fatima Sajid, Ismail Akbar, Muhammad Ayub Ashraf Mallhi
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Abstract

Objective: To compare the occurrence of hypocalcemia in patients undergoing subtotal and total thyroidectomy. Study Design: Comparative prospective study. Place and Duration of Study: Surgical departments of Ayub Teaching Hospital, Abbottabad and Combined Military Hospital, Rawalpindi, from Mar 2018 to Feb 2020. Methodology: A total of 171 patients were selected for this study and they were divided into 2 groups. Group 1 consisted of 95 patients undergoing Total thyroidectomy whereas group 2 had 76 patients undergoing Subtotal thyroidectomy. It was a comparative prospective study and the groups were made by convenience sampling. The data was analyzed by SPSS-23. Results: In total thyroidectomy group Hypocalcemia was detected after 48 hours in 34 patients (35%) while in subtotal thyroidectomy group hypocalcemia was detected in 20 patients (28%). Tests for hypocalcemia were also done after two months of surgery and low levels were detected in 7 patients (7.5%) who had total thyroidectomy and in 2 patients (5%) in the group undergoing subtotal thyroidectomy. There was no significant difference in hypocalcemia after 48 hour (p=0.22) and 2 months postoperatively (p=0.6) between patients of Total Thyroidectomy and Subtotal Thyroidectomy. Conclusion: Total thyroidectomy is not associated with increased risk of permanent hypocalcemia as compared to Subtotal thyroidectomy. Because of its advantages Total thyroidectomy should be the preferred surgical procedure for patients presenting with benign euthyroid multi nodular goiter.
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甲状腺全切除术与次全切除术中的低钙血症
目的:比较甲状腺次全切除术与甲状腺全切除术患者低钙血症的发生情况。研究设计:比较前瞻性研究。学习地点和时间:2018年3月至2020年2月,阿伯塔巴德阿尤布教学医院和拉瓦尔品第联合军事医院外科。方法:本研究共选取171例患者,分为2组。第一组95例患者行甲状腺全切除术,第二组76例患者行甲状腺次全切除术。本研究为前瞻性比较研究,分组采用方便抽样。采用SPSS-23软件对数据进行分析。结果:甲状腺全切除术组48 h后出现低钙34例(35%),甲状腺次全切除术组低钙20例(28%)。手术两个月后也进行了低钙检查,在甲状腺全切除术组的7例患者(7.5%)和甲状腺次全切除术组的2例患者(5%)中检测到低钙水平。甲状腺全切除术与甲状腺次全切除术患者术后48小时(p=0.22)和术后2个月(p=0.6)低血钙水平差异无统计学意义。结论:与甲状腺次全切除术相比,甲状腺全切除术与永久性低钙血症的风险增加无关。由于其优点,甲状腺全切除术应是表现为良性甲状腺功能正常的多结节性甲状腺肿患者的首选手术方法。
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