Is routine calcium supplementation necessary in patients undergoing total thyroidectomy plus neck dissection?

Surgery Today ◽  
2011 ◽  
Vol 41 (2) ◽  
pp. 183-188 ◽  
Author(s):  
Sheng-Dong Wu ◽  
Li Gao
Keyword(s):  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Calcium Supplementation

Evaluation of Hypoparathyroidism following Total Thyroidectomy

2020 ◽  
Vol 26 (2) ◽  
pp. 116-120
Author(s):  
Md Nazmul Haque ◽  
Saif Rahman Khan ◽  
Moshammat Fatima Akhter ◽  
Mohammad Ashequr Rahman Bhuiyan ◽  
Mohammad Zakaria Sarker ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Serum Calcium ◽  
Calcium Supplementation ◽  
Follicular Carcinoma ◽  
Sampling Technique ◽  
Multinodular Goitre ◽  
Period 2 ◽  
Parathyroid Function ◽  
Malignant Lesions

The most common cause of hypoparathyroidism is damage to the glands during thyroid surgery. Parathyroid gland preservation during thyroidectomy is not only desirable, but essential for the effective management of surgical diseases of the thyroid gland Objective: To find out the incidence rate of hypoparathyroidism after total thyroidectomy. Methods: Study Period: 2 years from Jan 2017 to December 2018 Place of Study : National Institute of ENT, Tejgaon, Dhaka Study Design: Prospective Observational Study Sample size: 107 Sampling Technique: Convenient Sampling technique Results: Among the 107 cases 39 cases were malignant comprising 36.45% of the cases. toxic multinodular goitre were 6 cases among 107 cases (5.6%) and rest 62 cases were benign multinodular goitre with or without cystic change and follicular adenomas (57.94 %). 29 cases out of 39 malignant cases were papillary carcinoma of thyroid (74.36% of malignant lesions), 2 cases of medullary Ca thyroid (5.12 % of malignant lesions) rest 8 were follicular carcinoma (20.51% of malignant lesions). 26 out of 107 (24.30%) cases suffered from postoperative hypocalcaemic tetany within 1st-5th POD. Their parathyroid hormones were significantly reduced and serum calcium were also reduced and they required calcium supplementation. In 5 (4.67%) cases there was no sign and symptoms of tetany but their serum parathormone levels were little below normal level but serum calcium levels were normal and therefore no calcium supplementation were given. The rest 76 (71.03%) cases did not show any sign or symptoms of tetany and did not require calcium supplementation. Among the patients who suffered from tetany majority were cases of Carcinoma of thyroid (18 out of 26 patients of hypoparathyroidism) 69.23%, however lateral neck dissection did not seem to affect decline in parathyroid function as 10 out of 18 patients with thyroid malignancy who suffered from postoperative tetany undergone level II to level V neck dissection in addition to total thyroidectomy. Bangladesh J Otorhinolaryngol; October 2020; 26(2): 116-120

Outcome of Thyroid Surgeries at Patan Hospital

2018 ◽  
Vol 6 (1) ◽  
pp. 11-14
Author(s):  
Deepak Yadav ◽  
Bhawana Dangol ◽  
Anita GC ◽  
Namita Shrestha ◽  
Ishwor Raj Devkota ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Central Compartment ◽  
Neck Surgery ◽  
Laryngeal Nerve ◽  
Completion Thyroidectomy ◽  
Lateral Neck ◽  
Lateral Neck Dissection

Objective: To assess the outcome of thyroid surgeries at Patan HospitalMaterials and Methods: It is a retrospective study of in-patient records of patients undergoing thyroid surgeries for various indications from April 2013 to January 2015 at Patan Hospital, Lalitpur.Results: During the period of 21 months, 75 patients underwent thyroid surgeries. Majority of patients underwent hemithyroidectomy (35) followed by total thyroidectomy (28), subtotal thyroidectomy (7) and completion thyroidectomy (5). Out of 28 patients undergoing total thyroidectomy (TT), 11 underwent central compartment clearance (CCC), 5 underwent CCC and lateral neck dissection. Among 5 patients undergoing completion thyroidectomy, CCC was performed in all cases and in one patient lateral neck dissection was also performed.  A total of 13 patients developed unilateral recurrent laryngeal nerve palsy (RLN), among them 5 had permanent palsy. Tracheostomy had to be done in immediate postoperative period for stridor following total thyroidectomy (TT) in one case. Temporary hypocalcaemia was observed in 10 (10/28) cases following TT, out of which 8 had undergone CCC. Permanent hypocalcaemia was observed in 7 (7/28) cases following TT out of which 3 had undergone CCC. Chylous leak occurred in one of the patient undergoing left level II-IV neck dissection which was managed conservatively. None of the patient had to be transfused postoperatively.Conclusion: Complications to thyroid surgery are not uncommon. Visualization of recurrent laryngeal nerve alone in our context is adequate in experienced hands. Identification of parathyroid during thyroidectomy is recommended to avoid hypocalcaemia. Meticulous dissection can reduce the complications.Nepalese Journal of ENT Head and Neck Surgery, Vol. 6, No. 1, 2015

scholarly journals Serum Magnesium: A Forgotten Electrolyte after Total Thyroidectomy

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Adi Syazni Muhammed ◽  
Shahrun Niza Abdullah Suhaimi ◽  
Qi Zheng Lee
Keyword(s):  
Atrial Fibrillation ◽  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Calcium Homeostasis ◽  
Serum Magnesium ◽  
Common Complication

Hypocalcemia is a common complication after total thyroidectomy; however, hypomagnesemia is also frequently detected, and its role is often disregarded. We report a 72-year-old woman who underwent total thyroidectomy with neck dissection and subsequently developed atrial fibrillation due to hypocalcemia and hypomagnesemia. The pathophysiology of hypomagnesemia after total thyroidectomy and its significance in calcium homeostasis is described.

scholarly journals Next-day Parathyroid Hormone as a Predictor of Post-thyroidectomy Hypocalcemia

2016 ◽  
Vol 8 (3) ◽  
pp. 203-207 ◽  
Author(s):  
MJ Paul ◽  
Thomas V Paul ◽  
Deepak T Abraham ◽  
Anish Cherian
Keyword(s):  
Parathyroid Hormone ◽  
Total Thyroidectomy ◽  
Predictive Value ◽  
Calcium Supplementation ◽  
Early Discharge ◽  
Tertiary Hospital ◽  
Vitamin D Supplementation ◽  
Postoperative Hypocalcemia ◽  
Parathyroid Dysfunction ◽  
Pth Level

ABSTRACT Aims Total thyroidectomy is significantly complicated by parathyroid dysfunction and hypocalcemia. These aspects impact the decision regarding the timing of discharge and quantum of calcium supplementation required. Therefore, we aimed at evaluating the accuracy of next-day parathyroid hormone (PTH) level as a predictor of post-thyroidectomy hypocalcemia. Secondly, we aimed at establishing our institution's postoperative PTH level, which can accurately predict the development of post-thyroidectomy hypocalcemia to help us ensure the safe and early discharge of patients. Materials and methods A prospective observational study of 50 continuous patients undergoing thyroidectomy was conducted at a tertiary hospital in South India. Postoperative blood samples were collected for estimation of PTH, calcium, albumin, and phosphorous. The data were collated and results analyzed using Stata I/C 10.1. Results A total of 30% (15/50) of the patients had postoperative hypocalcemia (serum calcium <8 mg/dL). Postoperative PTH was low (<8 pg/mL) in 40% (20/50) of patients. There was a significant association between PTH < 8 pg/mL and the presence of postoperative hypocalcemia (p = 0.029). The area under the receiver operating characteristic (ROC) curve was 0.7, and a next-day PTH of <6 pg/mL showed the highest sensitivity and specificity (83 and 60% respectively) for the development of postoperative hypocalcemia, with a positive predictive value (PPV) and negative predictive value (NPV) of 83 and 60 respectively. Conclusion The PTH assessment performed the day after surgery is an acceptable test to predict post-thyroidectomy hypocalcemia; PTH <6 pg/mL can be used as our institution's cutoff value. Department protocols for calcium and vitamin D supplementation following total thyroidectomy may be formulated based on the appropriately timed local postoperative PTH value to assist safe and early discharge of patients. Clinical significance Discharge protocols for patients undergoing thyroidectomy may be formulated based on the postoperative PTH values, thus enabling safe and early discharge of patients. How to cite this article Cherian AJ, Ramakant P, Paul TV, Abraham DT, Paul MJ. Next-day Parathyroid Hormone as a Predictor of Post-thyroidectomy Hypocalcemia. World J Endoc Surg 2016;8(3):203-207.

Six-Year Experience of Outpatient Total and Completion Thyroidectomy at a Single Academic Institution

2017 ◽  
Vol 83 (4) ◽  
pp. 381-384 ◽  
Author(s):  
Ethan Frank ◽  
Joshua Park ◽  
Alfred Simental ◽  
Christopher Vuong ◽  
Steve Lee ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Vocal Fold ◽  
Calcium Supplementation ◽  
Vocal Fold Paralysis ◽  
Completion Thyroidectomy ◽  
Rates Of Return ◽  
Hematoma Formation ◽  
Significant Difference ◽  
Permanent Hypocalcemia ◽  
Inpatient Group

Outpatient thyroidectomy has become slowly accepted with various published reports predominantly examining partial or subtotal thyroidectomy. Concerns regarding the safety of outpatient total and completion thyroidectomy remain, especially with regard to vocal fold paralysis, hypocalcemia, and catastrophic hematoma. We aimed to evaluate the safety of outpatient thyroid surgery in a large cohort by retrospectively comparing outcomes in those who underwent outpatient (n = 251) versus inpatient (n = 291) completion or total thyroidectomy between February 2009 and February 2015. Outpatient completion and total thyroidectomy had lower rates of temporary hypocalcemia (6% vs 24.4%; P < 0.001) and no significant difference in rates of return to emergency department (1.2% vs 1.4%), hematoma formation (0.8% vs 0.7%), temporary (2% vs 4.1%) or permanent (0.4% vs 0.7%) vocal fold paralysis, or permanent hypocalcemia (0.4% vs 0%) compared with the inpatient group. Outpatients requiring calcium replacement had shorter duration of postoperative calcium supplementation (44.4 ± 59.3 days vs 63.3 ± 94.4 days; P < 0.001). Our data demonstrate similar safety in outpatient and inpatient total and completion thyroidectomy.

Sign in / Sign up

Export Citation Format

Share Document