Role of preoperative serum calcium levels in predicting postoperative transient hypocalcemia in patients undergoing hemithyroidectomy surgery
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20252984Keywords:
Serum calcium levels, Hemithyroidectomy surgery, Postoperative transient hypocalcemiaAbstract
Background: There is increase in incidence of thyroid disease and thyroid surgery over the years, mostly affecting females. Hypocalcemia following thyroid surgery can be fatal and increases hospital stay and cost. Transient hypocalcemia in postoperative period following hemithyroidectomy is seldom seen and often overlooked. We studied the role of preoperative serum calcium levels in predicting the postoperative transient hypocalcemia in patients undergoing hemithyroidectomy.
Methods: This is a prospective study on patients undergoing hemithyroidectomy at tertiary care hospital from June 2022 to February 2023. The serum calcium levels were recorded preoperatively and in immediate postoperative period (within 24 hrs after surgery). The serum calcium level of 9-11 mg/dl was considered normal range and level below 9 mg/dl was considered as hypocalcemia.
Results: Gender distribution was 50 females (90.9%) and 5 males (9.09%) with mean age of 38.6 years. Out of 55 patients who underwent hemithyroidectomy, 15 patients had low serum calcium levels (<9 mg/dl) preoperatively. Out of these 15 patients, 10 patients (66.6%) developed postoperative transient hypocalcemia. None of the patients had symptoms of hypocalcemia in postoperative period.
Conclusions: The preoperative serum calcium levels can predict the postoperative transient hypocalcemia in patients undergoing hemithyroidectomy surgery. In two-thirds of patient who had serum calcium levels below 9 mg/dl preoperatively developed postoperative transient hypocalcemia. Further studies are required to know the cause of low serum calcium levels preoperatively and postoperative transient hypocalcemia in patients undergoing hemithyroidectomy surgery.
Metrics
References
Saibene AM, Rosso C, Felisati G, Pipolo C, Leo SD, Lozza P, et al. Can preoperative 25-hydroxyvitamin D levels predict hypocalcemia after total thyroidectomy? Updates in Surg. 2022;74(1):309-16. DOI: https://doi.org/10.1007/s13304-021-01158-5
Sosa JA, Hanna JW, Robinson KA, Lanman RB. Increases in thyroid nodule fine-needle aspirations, operations, and diagnoses of thyroid cancer in the United States. Surgery. 2013;154(6):1420-6. DOI: https://doi.org/10.1016/j.surg.2013.07.006
Chiu CG, Yao R, Chan SK, Scott SS, Samuel B, Robert I, et al. Hemithyroidectomy is the preferred initial operative approach for an indeterminate fine needle aspiration biopsy diagnosis. Can J Surg. 2012;55(3):191-8. DOI: https://doi.org/10.1503/cjs.034510
Bhattacharyya N, Fried MP. Assessment of the morbidity and complications of total thyroidectomy. Arch Otolaryngol. 2002;128(4):389-92. DOI: https://doi.org/10.1001/archotol.128.4.389
Kalyoncu D, Gonullu D, Gedik ML, Muzaffer E, Erol K, Ayşenur Aİ, et al. Analysis of the factors that have effect on hypocalcemia following thyroidectomy. Ulusal Cer Derg. 2013;29(4):171-6. DOI: https://doi.org/10.5152/UCD.2013.2438
Bergamaschi R, Becouarn G, Ronceray J, Arnaud JP. Morbidity and complication of total thyroidectomy. Am J Surg. 1998;176(1):71-5. DOI: https://doi.org/10.1016/S0002-9610(98)00099-3
Edafe O, Antakia R, Laskar N, Uttley L, Balasubramanian SP. Systematic review and meta-analysis of predictors of post-thyroidectomy hypocalcemia. BJS. 2014;101(4):307-20. DOI: https://doi.org/10.1002/bjs.9384
Amir A, Sands NB, Tamilia M, Hier MP, Black MJ, Payne RJ. Preoperative serum calcium levels as an indicator of post thyroidectomy hypocalcemia. J Otolaryngol Head Neck Surg. 2010;39:654-8.
Sitges-Serra A, Ruiz S, Girvent M, Manjo´n H, Duen˜ as JP, Sancho JJ. Outcome of protracted hypoparathyroidism after total thyroidectomy. Br J Surg. 2010;97(11):1687-95. DOI: https://doi.org/10.1002/bjs.7219
Kamer E, Unalp HR, Erbil Y, Akguner T, Issever H, Tarcan E. Early prediction of hypocalcemia after thyroidectomy by parathormone measurement in surgical site irrigation fluid. Int J Surg. 2009;7(5):466-71. DOI: https://doi.org/10.1016/j.ijsu.2009.07.006
Erbil Y, Barbaros U, Temel B, Turkoglu U, Issever H, Bozbora A, et al. The impact of age, vitamin D(3) level, and incidental parathyroidectomy on. Am J Surg. 2009;197(4):439-46. DOI: https://doi.org/10.1016/j.amjsurg.2008.01.032
Erbil Y, Bozbora A, Ozbey N, Issever H, Aral F, Ozarmagan S, et al. Predictive value of age and serum parathormone and vitamin D3 levels for postoperative hypocalcemia after total thyroidectomy for nontoxic multinodular goiter. Arch Surg. 2007;142(12):1182-7. DOI: https://doi.org/10.1001/archsurg.142.12.1182
Moriyama T, Yamashita H, Noguchi S, Takamatsu Y, Ogawa T, Watanabe S, et al. Intraoperative parathyroid hormone assay in patients with Graves’ disease for prediction of postoperative tetany. World J Surg. 2005;29(10):1282-7. DOI: https://doi.org/10.1007/s00268-005-7880-3
Yamashita H, Noguchi S, Tahara K, Watanabe S, Uchino S, Kawamoto H et al. Postoperative tetany in patients with Graves’ disease: a risk factor analysis. Clin Endocrinol (Oxf). 1997;47(1):71-7. DOI: https://doi.org/10.1046/j.1365-2265.1997.2201033.x
Downloads
Published
How to Cite
Issue
Section
