A comparative study of incidence of hypocalcemia following total, near total and sub total thyroidectomy

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Article type :

Research Article

Author :

Nousheen, Jamal Shaik

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Abstract :

Introduction: Surgical resection is the treatment of choice for the majority of patients with benign multinodular goiter (MNG) and well differentiated thyroid carcinoma. Surgical options for the management of MNG include subtotal thyroidectomy, Near total thyroidectomy and Total thyroidectomy. Although there is debate about the optimal surgical procedure for these patients, the choice of surgical technique must take into account the potential benefits and complications of each procedure. Aim: 1: To study the incidence of post-operative hypocalcaemia following thyroidectomy. 2: To compare the incidence of hypocalcaemia following Total thyroidectomy, Near total thyroidectomy and Subtotal thyroidectomy. Materials and Methods: A Cross sectional study conducted in Department of General Surgery, Shadan Institute of Medical Sciences Hospital, Hyderabad from October 2018 to August 2019 in 50 consenting patients who had undergone Total / Near total / Subtotal thyroidectomy. Prior to the selection they underwent routine history taking, physical examination and investigation to exclude preexisting hypocalcemia. The levels of corrected serum calcium [ Corrected calcium = Serum Calcium (0.8 X {4.0 – albumin}] are measured preoperatively every 24 hours till discharge and the first post operative OPD visit and at sixth month. Results: In the present study 17 patients underwent subtotal thyroidectomy, 17 patients underwent near total thyroidectomy and 16 patients underwent total thyroidectomy. Among subtotal thyroidectomy group 5 (29.4%) patients had transient hypocalcemia and 1 (5.8%) patient had persistent hypocalcemia. Among the Near total thyroidectomy group 9 (52.9) patients had transient hypocalcemia ,5 (29.41%) patients had persistent hypocalcemia and 2 (11.76%) patients had hypocalcemia symptoms. Among the Total thyroidectomy group 12 (70.05%) patients had transient hypocalcemia, 8 (47.05%) had persistent hypocalcemia and 6 (35.29%) patients had hypocalcemia symptoms. Conclusion: There is an increased incidence of hypocalcemia in patients undergoing Total thyroidectomy and Near total thyroidectomy when compared to Subtotal thyroidectomy. When comparing Total thyroidectomy and Near total thyroidectomy, hypocalcemia incidence is more in Total thyroidectomy. Meticulous surgical dissection and preservation of parathyroid glands is essential to avoid this complication.

Keyword :

Hypocalcemia, Transient Hypocalcemia, Persistent Hypocalcemia, Subtotal thyroidectomy, Near total thyroidectomy, Total thyroidectomy.
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