Related Experiment Video
Updated: Dec 7, 2025
Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Hypocalcemia prevention and management after thyroidectomy in children: A systematic review
Ankitha Radakrishnan1, Abhita T Reddy2, Prarthana Dalal1
1Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Insights
Hypocalcemia is a common complication after pediatric thyroidectomy, affecting 35.5% of children. Current practices for preventing and managing this condition in children vary significantly, highlighting a need for standardized guidelines.
Area of Science:
- Pediatric endocrinology
- Surgical outcomes
- Clinical practice guidelines
Background:
- Hypocalcemia is the most frequent complication following thyroidectomy in pediatric patients.
- Established guidelines for managing post-thyroidectomy hypocalcemia exist for adults but not for children.
- This review addresses the gap in pediatric-specific management protocols.
Purpose of the Study:
- To systematically review and identify current practices for preventing and managing hypocalcemia in children after thyroidectomy.
- To highlight variations in clinical approaches and identify areas for guideline development.
Main Methods:
- A systematic literature search was conducted across PubMed, EMBASE, Web of Science, and Cochrane databases.
- Studies involving pediatric patients undergoing thyroidectomy and examining hypocalcemia were included.
- Three independent reviewers screened citations and full-text articles.
Main Results:
- Fifteen studies, encompassing 1552 pediatric patients, were included in the review.
- The pooled incidence of transient hypocalcemia was 35.5%, and permanent hypocalcemia was 4.2%.
- Significant practice variations were observed in treatment and prevention strategies, with limited research on routine supplementation.
Conclusions:
- Post-thyroidectomy hypocalcemia is a significant concern in pediatric patients, with a high incidence.
- There is considerable heterogeneity in the prevention and management of hypocalcemia in children following thyroidectomy.
- The findings underscore the need for evidence-based guidelines tailored for pediatric care.
Introduction:
Hypocalcemia is the most common complication following thyroidectomy in children. Guidelines to manage post-thyroidectomy hypocalcemia are available for adults, but not children. The objective of this review was to identify practices related to hypocalcemia prevention and management in pediatric patients.
Methods:
We identified studies examining the prevention and management of hypocalcemia in pediatric patients post-thyroidectomy within PubMed, EMBASE, Web of Science and Cochrane databases. Three independent reviewers screened citations and reviewed full-text papers.
Results:
A total of 15 studies were included, representing 1552 patients. The overall study quality was weak with lack of randomization and inconsistent outcome reporting. The pooled incidence of hypocalcemia from the 15 studies was 35.5% for transient hypocalcemia and 4.2% for permanent hypocalcemia. All studies discussed post-operative hypocalcemia treatment, with most patients requiring admission for intra-venous calcium therapy. One study described a protocol discharging asymptomatic patients on calcitriol and calcium. Three studies discussed preoperative calcium supplementation in patients at risk of hypocalcemia. No studies examined routine use of calcium and/or vitamin D supplementation to prevent post-operative hypocalcemia.
Conclusion:
A significant number of children undergoing thyroidectomy develop hypocalcemia. Despite this high incidence, our systematic review demonstrates significant practice variation surrounding post-thyroidectomy hypocalcemia prevention and management in children.
Level Of Evidence:
III (systematic review of studies of which some were case-control studies (III) and some were case series (IV)).
Related Concept Videos
00:51Synthesis and Functions of Calcitonin
The exact mechanisms by which calcitonin operates in calcium homeostasis remain elusive, but its significance is evident in several vital...
01:21Skeleton and Calcium Homeostasis
01:17Hormones and Bone Tissue
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
00:59The Parathyroid Glands
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
01:20Synthesis and Regulation of Thyroid Hormones
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...