Incidence of Hypocalcaemia Following Different Thyroid Surgeries

Abstract

Hypocalcaemia from hypoparathyroidism is a well-recognized complication of thyroidectomy. It might be permanent in up to 10%, and temporary in up to 50%, of patients. It can take up to four days to reach its nadir, and can lengthen a patient’s hospital stay considerably. There are three hormones that are primarily concerned with the regulation of calcium metabolism. Parathyroid hormone (PTH) 1, 25 dihydrocholecalciferol (Vit.D), and calcitonin. All the three hormones probably operate in concert to maintain the constancy of the calcium level in the body fluids. This study was done to assess the incidence of hypocalcemia after different form of thyroid surgery through measuring total serum calcium, ionize serum calcium and PTH after thyroid surgery and compare with their level before surgery. This study included thirty patients underwent different forms of thyroidectomy for simple nodular goiter. They were allocated into three equal groups of ten patients each. In group one total thyroidectomy was done. In group two near total thyroidectomy was done and in group three subtotal thyroidectomy was done. Preservation of parathyroid glands and their blood supply was attempted in all cases. Pre-operative PTH and serum calcium were estimated for the three groups, postoperative serum calcium was estimated on day one and day six postoperatively, the PTH was estimated six-hours postoperative in the three groups. The postoperative serum calcium and PTH were reduced on day one after all types of thyroidectomy but they were much apparent after total and near total thyroidectomy than after subtotal thyroidectomy, although they were within normal range. The early detection of post thyroidectomy hypocalcemia through measuring serum calcium in day one and PTH six hours postoperative is important to decrease the post thyroidectomy morbidity and mortality.