Abstract
Introduction: Thyroidectomy has been established as the preferred operation for various thyroid disorders in various forms, ranging from hemithyroidectomy, subtotal to total thyroidectomy. Postoperative hypocalcaemia is one of the most common complications that is observed in patients who undergo total thyroidectomy. To minimise the postoperative complications and to minimise hospital stay and early discharge, it is important to predict patients at risk of developing hypocalcaemia. Measurements of Parathyroid Hormone (PTH) in the immediate postoperative period along with serum calcium are useful and reliable methods. Aim: To determine the risk of post total thyroidectomy by measuring PTH level after total thyroidectomy and compare serum calcium and magnesium levels pre and two hours post total thyroidectomy. Materials and Methods: A prospective observational study was conducted on 34 patients, who underwent total thyroidectomy, from October 2018- May 2020. Preoperative calcium, magnesium and PTH were compared with postoperative calcium, magnesium and PTH. All data were analysed using Statistical Package for the Social Sciences (SPSS) for Windows, Version 22.0. Paired t-test was used to compare and find an association. results: Present study included six males (17.6%) and 28 females (82.4%), there was statistically significant difference between postoperative calcium levels in total thyroidectomy without central neck dissection (mean of 8.36) and postoperative calcium levels in total thyroidectomy with neck dissection (mean of 7.67). There was a significant statistical association between postoperative calcium and postoperative PTH levels (p<0.001). Present study observed significant positive correlation coefficient (r=0.698) and a high level of significance (p<0.001) for postoperative calcium and postoperative PTH. Present study showed no definitive correlation between postoperative serum magnesium and calcium levels. conclusion: For predicting the risk of hypocalcaemia after thyroidectomy it is more reliable to measure the serum PTH level before and after operation and compare the reduction level of percentage of PTH drop for predicting the risk of hypocalcaemia.
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