title: [Post-thyroidectomy hypocalcemia. Personal experience].
abstract: BACKGROUND
  The study evaluates the incidence of both early and protracted post-thyroidectomy hypocalcemia over a 6-year period (1995-2000) in a series of 330 consecutive thryoid operations. The aim was to identify the profile of patients with the greatest risk of permanent parathyroid functional insufficiency and a suitable treatment protocol.
  
  
  METHODS
  Having performed a statistical ana-lysis of all the variables, we divided the entire population of 330 patients into 4 groups based on the extent of demolition, the method of organotherapeutic replacement with L-Thyroxine and the (eco-radioguided) procedure used to identify the parathyroids: 59 patients undergoing subtotal thyroidectomy; 155 patients undergoing total thyroidectomy who commenced replacement organotherapy from postoperative day 15-30; 94 patients undergoing total thyroidectomy who commenced replacement organotherapy from postoperative day 1; 22 patients undergoing total thyroidectomy who underwent routine intraoperative parathyroid assay.
  
  
  RESULTS
  The results show that the impact of more radical surgery in determining hypocalcemia, in particular protracted hypocalcemia, represents the most striking characteristic of patients with the greatest probability of permanent parathyroid insufficiency. We emphasise that early correction of postoperative hypothyroidism can drastically reduce the incidence of both early and protracted hypocalcemia.
  
  
  CONCLUSIONS
  In conclusion, hypoparathyroidism is an exceptional event, whereas hypocalcemia is relatively common after total thyroidectomy. The effects of the early correction of postoperative hypothyroidism are undoubtedly beneficial, as is the use of eco- and radioguided methods for the intraoperative identification of the parathyroid glands, although they are not free from limits and criticism.
authors.affiliation: V Divisione di Chirurgia Generale, Seconda Università degli Studi, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: De Falco
authors.forename: D
authors.initials: D
authors.lastname: Parmeggiani
authors.forename: C
authors.initials: C
authors.lastname: Giudicianni
authors.forename: A
authors.initials: A
authors.lastname: Lanna
authors.forename: A
authors.initials: A
authors.lastname: Miranda
authors.forename: G
authors.initials: G
authors.lastname: Oliva
authors.forename: U
authors.initials: U
authors.lastname: Parmeggiani
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood* / Q000453:epidemiology; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000009:adverse effects*