Pre-operative Calcium and Vitamin D: The Solution of Post-operative Total Thyroidectomy Hypocalcemia
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Abstract
Introduction: Postoperative hypocalcemia is one of the most common complications of total thyroidectomy. Presence of postoperative symptomatic hypocalcemia is managed by calcium and vitamin D supplementation.
Aim of the work: To compare the frequency of transient hypocalcemia after vitamin D and calcium supplementation with the control group patients undergoing total thyroidectomy in Tobruk-Libya
Patients, Materials and Methods: It was a randomized controlled trial conducted at Surgery and Nutrition departments of Tobruk Medical Center, Libya, from January 2020 to July 2020. A total of 84 patients of both genders - between the age of 20-69 years and undergoing total thyroidectomy - were included in the study. Patients then were randomly distributed into two groups; Group 1 (n = 42) in which Vitamin D (200,000 IU) and calcium (1 gm) was given 24 hours pre-operatively. Group 2 (n = 42) was the control group.
Results: The mean age of the patients at group 1 is 34 years (range, 20–48 years) and at group 2 is 50.5 years (range, 32–69 years). Mean pre-operative calcium levels are 9.32 mg/dl in group 1 and 9.53 mg/dl in group 2. Hypocalcemia after total thyroidectomy was seen in 4 patients (9.5%) in group 1 as compared to 13 patients (30.9%) in group 2. There was a statistically significant difference among those who developed hypocalcemia in groups 1 & 2 (P = 0.0145). There is no significant association with gender and reason of thyroidectomy.
Conclusion: Postoperative hypocalcemia develops in all age groups in both males and females who undergo total thyroidectomy without preoperative calcium and vitamin D supplements. Postoperative hypocalcemic manifestations could be avoided by using preoperative vitamin D and calcium.
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