Is there enough evidence to recommend preoperative calcium and vitamin D in patients who undergo total thyroidectomy?

1 www.kosinmedj.org Hypoparathyroidism or hypocalcemia after total thyroidectomy occurs in up to 46% of patients temporarily and in 6.6% permanently [1,2]. It may be caused by inadvertent removal or devascularization of the parathyroid gland during surgery [3]. Therefore, surgeons should identify the parathyroid gland and preserve its vasculature to preserve the function. Even for experienced surgeons, post-thyroidectomy hypoparathyroidism is unavoidable in some cases, and the incidence may be higher for less experienced surgeons [4]. Management of post-thyroidectomy hypoparathyroidism includes supplementation of calcium and vitamin D, perorally or intravenously [5]. There have been several studies demonstrating the advantages of prophylactic calcium and vitamin D supplementation before surgery to prevent post-thyroidectomy hypocalcemia [6-9]. In a retrospective study of 65 patients who underwent total thyroidectomy, Maxwell et al. [7] presented that preoperative calcium and calcitriol supplementation for 5 days, in addition to routine postoperative supplementation, was associated with reduced incidence Editorial