HYPOCALCEMIA AND HYPOPARATHYROIDISM AFTER NEAR TOTAL THYROIDECTOMY:

Abstract

Background : Post-operative hypocalcemia is a common and usually a transient event after thyroidectomy due to iatrogenic injury to the parathyroid glands. Most of the studies had investigated the frequency of surgical complications in Total thyroidectomy patients. Unfortunately, very few studies had investigated about the hypocalcemia and hypoparathyroidism frequency in near total thyroidectomy patients post-surgically Aims: . We carried out this study to evaluate the hypothyroidism and hypoparathyroidism frequency in thyroid disorder patients who underwent near total thyroidectomy. Methods: We performed a retrospective analysis of 202 patients who underwent near-total thyroidectomy at our institution from May 2017 to April 2022. Institutional Ethical committee approval was taken and Waiver of consent was taken from the head of the surgery department before the data collection. Post near-thyroidectomy patients who were above 18 years old with normal preoperative serum calcium levels (i.e., 8.4-10.2µL) were included. The patients who underwent subtotal thyroidectomy, thyroidectomy with neck dissection, hemi-thyroidectomy, concurrent lymph nodes dissection, complete thyroidectomy following hemi-thyroidectomy, parathyroid auto transplantation and those who received calcium supplementation before surgery were excluded from the study. Therefore, medical records of 478 patients were reviewed and nally 202 patients were included in the study who fullled both the inclusion and exclusion criteria. Conclusion: The results obtained conrm that transient hypocalcemia can be observed after any operation; and particularly responsible is the decrease of the calcium concerning the proteins. We found that post-operative hypoparathyroidism is due to injury to the parathyroid glands (parathyroid ischaemia or surgical ablation of one or more glands). Here we see the delayed serum calcium level < or = 7.5 mg/dl or the delayed serum phosphorous level > 7.4 mg/dl. The results of our study, with 2 patients presenting transient post-operative hypoparathyroidism, contribute in conrming that the extracapsular total thyroidectomy aimed to reduce any injury to the parathyroid and to the recurrent nerves, represent the better operation also for the extended benignant thyroidopathies.