Hypocalcaemia after total thyroidectomy: incidence, control and treatment

Area of Science:

• Endocrinology
• Surgical Complications
• Thyroid Surgery

Background:

• Hypocalcaemia is the most frequent complication following total thyroidectomy, though often temporary.
• Understanding risk factors is crucial for managing this common postoperative issue.

Purpose of the Study:

• To identify factors contributing to a higher risk of hypoparathyroidism after total thyroidectomy.
• To correlate hypoparathyroidism risk with etiological factors and surgical procedures.

Main Methods:

• Analysis of 254 total thyroidectomy cases.
• Evaluation of the incidence of transient and permanent hypocalcaemia.
• Assessment of etiological and surgical factors influencing hypocalcaemia.

Main Results:

• Transient hypocalcaemia occurred in 29.1% of patients; permanent hypocalcaemia in 4.7%.
• Completion thyroidectomy cases showed lower hypocalcaemia rates (12%) compared to single-operation total thyroidectomies (31%).
• Graves-Basedow disease patients had a 50% incidence of postoperative hypocalcaemia; parathyroid function recovery averaged 5.2 months.

Conclusions:

• Postoperative hypocalcaemia is frequent but seldom permanent after total thyroidectomy.
• Graves-Basedow disease is associated with increased hypocalcaemia risk, necessitating closer patient follow-up.
• Postoperative calcium level monitoring at 24 and 48 hours is not effective for early identification of high-risk patients.