Short-Term Hypocalcemia Prophylaxis With Calcitriol Before Thyroidectomy.

Area of Science:

• Endocrinology
• Surgical Oncology
• Clinical Nutrition

Background:

• Postoperative hypocalcemia is a common complication following total thyroidectomy, impacting patient recovery and quality of life.
• Low vitamin D levels are a known risk factor, but the effectiveness of preoperative vitamin D supplementation remains uncertain.
• This study investigates the role of preoperative vitamin D administration in mitigating postoperative hypocalcemia.

Purpose of the Study:

• To evaluate the efficacy of short-term preoperative calcitriol administration in preventing postoperative hypocalcemia after total thyroidectomy.
• To assess the impact of preoperative vitamin D on the incidence and duration of hypocalcemia.
• To explore variations in hypocalcemia rates across different surgical centers.

Main Methods:

• A multicenter, randomized trial involving patients scheduled for total thyroidectomy.
• Patients received either calcitriol or no treatment in the days leading up to surgery.
• The primary outcome measured was the absence of hypocalcemia (serum calcium <2.1 mmol/L) post-surgery.

Main Results:

• No significant difference was observed in the rate of postoperative hypocalcemia between the calcitriol group (29.2%) and the control group (33.6%).
• The duration of hypocalcemia was significantly shorter in the group that received calcitriol (3.5 days) compared to the control group (7 days).
• Significant variability in hypocalcemia rates (13.9% to 71.4%) was noted across participating hospitals.

Conclusions:

• Short-term preoperative calcitriol administration does not alter the incidence of hypocalcemia following total thyroidectomy.
• Preoperative calcitriol supplementation can reduce the duration of postoperative hypocalcemia.
• Observed variations in hypocalcemia rates may be attributed to differences in surgical techniques among institutions.