Analysis of factors affecting the development of hypocalcaemia after multinodular goitre surgery.

Abstract

Thyroidectomy is acommon surgery performed especially in treatment of multinodular goitre. The most common post-thyroidectomy complication is apostoperative hypocalcaemia, and the percentage of postoperative hypoparathyroidism could reach even 50%. Tested group and methods: Aforward-looking, randomized testing was done on agroup of 113 women being subject to multinodular goitre surgery. In this article, we wish to present an analysis of the results obtained in the control group, focusing on the predicative factors which determine the development of postoperative hypocalcaemia. Obtained results: The rate of postoperative biochemical hypocalcaemia development was significantly higher in the group of patients, where the preoperative calcium concentration was lower than 2,4 mmol/l. In that group, the development of biochemical hypocalcaemia was observed in 93,7% of cases (30 out of 32 patients), in comparison with 65,3% (17 out of 26) in the group of higher preoperative concentration of calcium. The highest risk of occurrence of postoperative hypocalcaemia was borne bythe total thyroidectomy, while the lowest one bythe subtotal thyroid lobectomy of one lobe only. Ahigher preoperative concentration of calcium in blood serum is related to the lower rate of occurrence of postoperative biochemical hypocalcaemia. However, no such correlation was revealed in the case of postoperative symptomatic hypocalcaemia. Lack of correlation was determined between the preoperative concentration of TSH and FT4 in blood serum and therate of occurrence of postoperative hypocalcaemia, both symptomatic and asymptomatic. The performed statistics did not reveal arelation between the postoperative hypocalcaemia and the duration of the surgery, but asignificant correlation was stated with the scope of the performed surgery. Revealing arelation between the rate of occurrence of postoperative hypocalcaemia and the experience of the surgeon performing the surgery was not successful.