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Updated: Mar 24, 2026

Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
[Risk of hypocalcemia after thyroid surgery]
A M Shulutko1, V I Semikov1, S E Gryaznov1
1Chair of Faculty Surgery #2, I.M. Setchenov First Moscow State Medical University, Moscow, Russia.
Aim:
To reveal calcium metabolism disorders that frequently occur after thyroid surgery.
Material And Methods:
The study included 202 patients who underwent thyroid surgery for different diseases and had normal calcium level in peripheral blood at baseline.
Results:
Based on laboratory data postoperative hypocalcemia was diagnosed in 57 (28.8%) patients. It was not always accompanied by clinical symptoms. Clinical picture depended on degree of hypocalcemia. Symptoms was diagnosed more frequently if calcium concentration was less than 2.1 mmol/l. Clinical manifestations were absent in 64.9% of cases on background of hypocalcemia. Incidence of hypocalcemia was higher after thyroidectomy compared to organ-preserving surgery. Symptoms of hypocalcemia occurred after thyroidectomy only. Casual parathyroidectomy does not always cause hypocalcemia. Only in 14% of patients with hypocalcemia excised parathyroid was identified in specimen. At the same time 7.6% of patients with postoperative normocalcaemia also had excised parathyroids in specimens. Symptoms of hypocalcemia does not always occur at 1 day after surgery. They can appear later, for example at 5 days postoperatively and depend on severity of hypocalcemia. Thyroidectomy has high risk of postoperative hypocalcemia with clinical symptoms (19.6%) that is transient in 15.5% of cases and permanent in 4.1% of patients.
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