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Does Preoperative Calcium and Calcitriol Decrease Rates of Post-Thyroidectomy Hypocalcemia? A Randomized Clinical

Colleen Donahue1, Haddon J Pantel2, Bharat B Yarlagadda1

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|February 25, 2021
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Summary
This summary is machine-generated.

Prophylactic preoperative supplementation with calcium and calcitriol does not reduce hypocalcemia after total thyroidectomy. Postoperative supplementation alone is as effective, indicating routine preoperative supplementation is not supported.

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Area of Science:

  • Endocrinology
  • Surgical Complications
  • Thyroid Surgery

Background:

  • Postoperative hypocalcemia is a common complication following thyroidectomy.
  • Current practice involves postoperative calcium and calcitriol supplementation to mitigate this risk.
  • The efficacy of prophylactic preoperative supplementation remains unexamined.

Purpose of the Study:

  • To evaluate if pre- and postoperative calcium and calcitriol supplementation reduces postoperative hypocalcemia after total thyroidectomy compared to postoperative supplementation alone.

Main Methods:

  • A prospective randomized trial involving 82 patients undergoing total thyroidectomy.
  • Intervention group received calcium and calcitriol preoperatively and postoperatively.
  • Control group received these supplements postoperatively only.

Main Results:

  • No significant difference in hypocalcemia rates between the groups (13.2% vs 15.9%, p=0.76).
  • No significant differences observed in secondary outcomes, including calcium levels, intervention needs, length of stay, or readmissions.

Conclusions:

  • Preoperative calcium and calcitriol supplementation does not offer additional benefit in preventing hypocalcemia post-thyroidectomy.
  • The findings do not support routine preoperative supplementation with calcium and calcitriol before total thyroidectomy.