Evaluation of Early & Late Hypocalcemia Post Total Thyroidectomy in the Early Learning Curve Retrospective Study

Abstract

Abstract Background Hypocalcemia post total thyroidectomy, is one of the most common complications observed in patients who undergo bilateral thyroid resection. Although hypocalcemia is self-limiting in most patients and does not require treatment, symptomatic hypocalcemia is of particular concern. We aimed to evaluate the incidence of hypocalcemia post total thyroidectomy with an evaluation of serum calcium levels as a cheap and available method so we can identify patients at risk of postoperative hypocalcemia who require supplementation treatment, and those not at risk who can be safely discharged without any supplementation treatment. Aim of the Work To analyze the data of post total thyroidectomy regarding calcium level temporary and permanent in the early learning curve and compare it with the standard incidence of developing hypocalcemia with total thyroidectomy in the literature. Patients and Methods Retrospective analysis of 120 patients undergoing total thyroidectomy. Preservation of parathyroid glands and their blood supply was attempted in all cases. The patients were assessed for manifestations of hypocalcaemia after thyroidectomy. The assessment was done through (1) monitoring the total and ionized calcium level 24 hours postoperatively, (2) Total and ionized calcium level was measured in the third week postoperative, (3) clinical examination and detection of symptoms and signs of hypocalcaemia, (4) In resistant cases assessment of total and ionized calcium and PTH at 3 and 6 months. Results The study included 103 females and 17 males, 37 was the mean age; 15 patients developed symptoms of hypocalcaemia all of them recovered from hypocalcaemia except 1 patient. Conclusion There is no difference between the incidence of temporary and permanent hypocalcemia in the early learning curve and the standard incidence of temporary and permanent hypocalcemia post total thyroidectomy