Post Total Thyroidectomy Hypocalcaemia and relation with the Age of the Patient (original) (raw)
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International Surgery Journal, 2021
Background: Hypocalcemia is one of the most common complications of thyroid surgery. It is usually temporary, but it may rarely take several months to resolve. The aim of this study was to determine the incidence of hypocalcaemia after total thyroidectomy and assess the biochemical factors that may be predictive of hypocalcemia.Methods: An observational study was conducted in 98 patients at the general surgery department of a tertiary care medical college hospital for a period of one year. Convenient method of sampling was done. All the patients undergoing total thyroidectomy were included in this study. The serum calcium level was evaluated at different times in the post-operative period as a part of the routine post-operative care at the hospital. During the postoperative period patients were carefully watched for clinical symptoms and signs of hypocalcemia.Results: In the study group, 19 (19.4%) had hypocalcemia. In the study group, 14 (14.3%) had symptomatic hypocalcemia and 5 p...
The Professional Medical Journal
Objective: To determine the frequency of post-operative asymptomatic hypocalcaemia in patients with total and subtotal thyroidectomy. Study Design: Cross-sectional study. Setting: Department of Surgery, Sheikh Zayed Hospital, Rahim Yar Khan. Period: 1st July 2021 to 30th April 2022. Material & Methods: One hundred and Sixteen post thyroidectomy male and female patients of age 18-50 years were included in the study using consecutive sampling technique and two groups were formed. Group-A included those patients who underwent total thyroidectomy and in Group-B patients underwent sub-total thyroidectomy. Samples for serum calcium levels were collected in gel tube before and 24 hours after surgery. Post-operative Hypocalcemia was defined by serum total calcium < 8.5 mg/dL 24 hours after surgery. Patients with symptomatic post-operative hypocalcemia following total or subtotal thyroidectomy or hypocalcemia due to any other reason or systemic disease e.g. renal disease and pregnant fema...
RATE OF OCCURRENCE OF POST-SURGICAL HYPOCALCAEMIA AMONG PATIENTS WHO UNDERWENT TOTAL THYROIDECTOMY
Objective: All the patients who underwent total thyroidectomy are present with high risk for post-surgical hypocalcaemia, which can cause a significant morbidity for short as well as long terms. The rate of occurrence of post-surgical hypocalcaemia in the patients who underwent total thyroidectomy. Methodology: A sum of total 854 patients who had to undergo total thyroidectomy from 2012 to 2019 at Surgical Department of Allied Hospital Faisalabad were the participants of this study. The collection of the data carried out for the characteristics of demography, diagnosis before surgical intervention, levels of calcium after surgery, extent of operation and final pathology after surgery. Results: A sum of total 854 patients underwent total thyroidectomy. Among total patients, 748 (87.58%) patients were malignant and 106 (12.41%) patients were benign. In both types of patients, 404 (47.30%) patients underwent total thyroidectomy and 450 (52.69%) patients had to undergo completion thyroidectomy. Overall rate of occurrence of transient hypocalcaemia was 7.0% (n: 60) and rate of occurrence of permanent hypocalcaemia was 0.110% (n: 1). Conclusion: Hypocalcaemia is matter of serious concern after the total thyroidectomy. Scrupulous techniques of surgery, detection and protection of vascularity of parathyroid glands are important in the prevention of hypocalcaemia after surgical intervention of total thyroidectomy.
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Postoperative hypocalcaemia is a common complication after total thyroidectomy but most often it is transient. Although these are mostly amenable to calcium and vitamin D supplementation, symptomatic patients sometimes need prolonged hospitalization following thyroid surgery, leading to increased healthcare costs. In the present study, we tried to find out factors which can predict the occurrence of post-operative hypocalcaemia & hypoparathyroidism in total thyroidectomy patients, facilitating their early detection and institution of definitive management in time, preventing emergency admissions & catastrophes. METHODS A prospective observational study was carried out in the Department of ENT & Head-Neck Surgery of a tertiary care govt. hospital in eastern India. Patients who underwent total thyroidectomy for multinodular goitre (MNG) and adenomatoid goitre (AG) or total/completion thyroidectomy for well differentiated thyroid carcinomas (WDTC), in the age group of 20-55 years were included in our study. We recorded the following parameters: Age, gender distribution of cases, type of operation, pre-operative Fine Needle Aspiration Cytology (FNAC) status, size of thyroid nodule operated (based on pre-operative ultrasonographic study), number of parathyroid glands preserved during operation, pre-operative vitamin D levels, post-operative serum calcium levels at 6 hours & 12 hours (positive i.e. increasing slope & non-positive i.e. decreasing/non-changing slope), early post-operative serum iPTH levels (at 6 hours), development of symptomatic hypocalcaemia-transient or permanent. RESULTS In the present study we measured serum calcium level 6 hours & 12 hours post-operatively. It has been found that patients with serum calcium levels on positive slope have lesser chances of occurrence of symptomatic hypocalcaemia & permanent hypocalcaemia than those on non-positive slope. We found that patients having serum iPTH level between 15-65 pg/ml showed lesser propensity to develop hypocalcaemia in comparison with those with serum iPTH level <15 pg/ml. In our study, it has been found that all the 3 cases who developed permanent hypocalcaemia were suffering from vitamin D deficiency; whereas, patients with normal vitamin D levels posed lesser risk of developing significant hypocalcaemia. In our observation, patients with only two parathyroid glands identified per-operatively have more chances of developing hypocalcaemia & those in whom all four parathyroid glands were preserved, very low risk of hypocalcaemia is associated. Furthermore, preservation of functional parathyroid gland with intact blood supply is found to be of immense importance than mere identification of the glands. In our series, it has been noted that with increase in the size of thyroid nodule, chances of hypocalcaemia increases. Patients undergoing complete thyroidectomy for histopathological report of WDTC in a previously benign (based on pre-operative FNAC) thyroid nodule, increased chances of development of post-operative hypocalcaemia. CONCLUSIONS Development of hypocalcaemia post thyroidectomy is multifactorial, some of which are predictable & some of which are correctable, either pre or post operatively, in order to reduce the chances of development of hypocalcaemia. Assessment of these factors helps in early identification of patients who are prone to develop significant hypocalcaemia in combination with the peroperative factors & ultimately helps in early institution of definitive replacement therapy, preventing unnecessary emergency readmission & helps in reducing the duration of hospital stay by facilitating early discharge, thus overall reducing burden on the healthcare system.
Frequency of Hypocalcaemia following Total Thyroidectomy
Pakistan Journal of Medical Sciences
Background & Objective: Patients who undergo Total thyroidectomy are at higher risk for postoperative hypocalcaemia, which can lead to significant short and long term morbidity. The aim of this study was to determine the frequency of postoperative hypocalcaemia undergoing Total thyroidectomy. Methods: A total of 854 patients who underwent Total thyroidectomy and completion thyroidectomy between January 2003 to December 2016 at Endocrine Surgical unit, Jinnah Postgraduate Medical Centre, Karachi, were included in this retrospective study. Data were obtained for demographics, preoperative diagnosis, postoperative calcium levels, extent of surgery and final surgical pathology. Results: A total of 854 patients underwent Total thyroidectomy. Of these 87.58% (n=748) were malignant and 12.41% (n=106) were benign. Among the malignant and benign patients, 47.3% (n=404) underwent Total thyroidectomy and 52.69% (n=450) underwent completion thyroidectomy. Overall incidence of transient hypocalc...
Study of hypocalcemia and its risk factors in post thyroidectomy among a sample of Iraqi patients
International Surgery Journal, 2018
Background: Hypocalcemia is a well-recognized complication of thyroid surgery. The aim of this study was to determine the incidence of hypocalcemia after thyroid surgery and find out the risk factors involved regarding the patient age, gender, muscular build, clinical diagnosis, extent of surgery, ligation of the inferior thyroid artery, and pathology report.Methods: This prospective study was carried out on 50 patients who underwent thyroid surgery for various thyroid diseases at the surgical department of Karama teaching hospital for the period between January 2016 to July 2016. Serial serum calcium measurements were recorded as well as details of the operation, patient age and gender, ligation of the inferior thyroid artery or not, pathological report. Hypocalcemia was considered transient if it was resolved within 6months and permanent if it persist after 6months and the patient was maintained on supplementation therapy of calcium and vitamin D.Results: Author found that the inc...
Necessity of therapy for post-thyroidectomy hypocalcaemia: a multi-centre experience
Langenbeck's Archives of Surgery, 2015
Purpose Hypoparathyroidism is one of the most common and most feared complications of total thyroidectomy (TT). The aim of this study is to detect possible markers that may facilitate early tracing of hypocalcaemia-prone patients in order to reduce clinical cost by optimizing patient discharge and to avoid unnecessary treatment. Methods Over an 18-month period, 995 patients, 23 % male and 77 % female, aged 52.9±13.4 years, underwent TT in ten Lombardy hospitals. The following parameters were analyzed: calcaemia before and 12-24 and 48 h after surgery, pre-and post-operative parathyroid hormone (PTH) at 24 h and pre-operative 25OH vitamin D.
East and Central …, 2009
Background: Thyroidectomy is one of the major and delicate operations commonly performed in surgical units. This study was aimed at determining the incidence of hypocalcaemia after thyroidectomy operation among patients who underwent thyroidectomy in two teaching hospitals in the north of Jordan. Methods: This was a retrospective study of 152 patients who underwent thyroidectomy in two teaching hospitals in the north of Jordan. Their medical records were reviewed to evaluate the incidence of post-thyroidectomy hypocalcaemia. Information about sex, age, extent of surgery, thyroid pathology, serum calcium level and the inadvertent removal of parathyroid glands during thyroidectomy was collected. Results: Postoperatively, 44 (29.0%) patients had their serum calcium decreased but remained within the normal range. Ten (6.6%) of the patients had transient hypocalcaemia while 4 (2.6%) had permanent hypocalcaemia. Most patients with hypocalcaemia had benign disease. Ten (6.6%) patients had had inadvertent removal of parathyroid glands but only one of them had transient hypocalcaemia. Conclusions: The incidence of post-thyroidectomy hypocalcaemia is low but exists and should be considered as a possible post-thyroidectomy complication.
International Surgery
Objective: The aim of this study was to compare 2 groups of patients, normocalcemic and hypocalcemic, 6 to 12 months after total thyroidectomy and to determine the clinical value of the calcium levels on hospital discharge. Summary of background data: Thyroid surgeries are among the most common operations performed in the world. Hypocalcemia after total thyroidectomy is a common complication that is sometimes difficult to correct. Methods: From January 2015 through April 2017, 400 patients were included in this prospective multicenter study. All the patients underwent total thyroidectomy. By way of random of selection, 2 groups of patients were formed: 30 patients who had a normal level of calcium detected in the blood on discharge from the hospital after total thyroidectomy (normocalcemia group), and 30 patients who had a reduced level of calcium in the blood on discharge from the hospital (hypocalcemia group). In these groups of patients, various parameters were determined. Result...
BACKGROUND: Post-operative hypocalcemia is a common event after extensive thyroid surgery. It can be transient or permanent. It can symptomatic or asymptomatic.symptomatic patients can present with mild or severe symptoms accordinlg to which correction of serum calcium levels may be required. AIMS: Our study is to evaluate the incidence of hypocalcemia after total thyroidectomy,to analyse the severity of presentation and to study about various modalities of treatment available. METHODS: The study was carried out in 50 patients (42 females and 8 males, whose age was between 20 and 65 years, who had undergone total thyroidectomy (TT) in our department from 2016 to 2018 RESULTS: Post-operative hypocalcemia was observed in 20 patients and the decrease of the serum calcium level lasted about 3 days, and went back to normal within the 5th day. Of those 20 patients , 5 patients had mild symptoms ,others were asymptomatic.In 2 patients out of the 50 who underwent total thyroidectomy, hypocalcemia was severe (confirmed for more than 7 days, symptomatic),both of them underwent total thyroidectomy with neck nodal dissection. In both cases the clinical and biological aspects went back to normal within 10 days, after a treatment with calcium and vitamin D. CONCLUSION: The results obtained confirm that transient hypocalcemia is a common feature in post thyroidectomy patients. Of those asymptomatic hypocalcemia is common. We found that post-operative hypocalcemia may be due to transient parathyroid gland ischemia or handling during surgery or accidental to injury to the parathyroid glands (parathyroid ischaemia or surgical ablation of one or more glands.The results of our study, show that radical thyroid surgeries with central neck node dissection can lead to inadvertent injury of parathyroids that may result in transient mild or prolonged severe hypoparathyroidism and hence hypocalcemia. Surgeries done under meticulous care can avoid such problems.