Is therapy with calcium and vitamin D and parathyroid autotransplantation useful in total thyroidectomy for preventing hypocalcemia?
BACKGROUND
Routine calcium and vitamin D administration and routine autotransplantation of parathyroid glands can prevent hypocalcemia after total thyroidectomy.


METHODS
Routine autotransplantation of 1 or more parathyroid glands and oral calcium and vitamin D supplementation was used in 252 patients.


RESULTS
One, 2, or 3 parathyroid glands were autotransplanted in 223, 27, and 2 patients, respectively. Routine oral calcium and vitamin D was administered in postoperative period in all patients. Postoperative hypocalcemia occurred in 17%, of whom 1.6% had minor symptoms related to hypocalcemia. No patient developed permanent hypocalcemia during the follow-up period. The postoperative stay was 1 day in 93.6% of the cases. The incidence of postoperative hypocalcemia and hospital stay was higher in patients who underwent autotransplantation of more than 1 parathyroid gland.


CONCLUSIONS
Routine oral calcium and vitamin D supplementation and autotransplantation of at least 1 parathyroid gland effectively reduced symptomatic hypocalcemia and permanent hypoparathyroidism in total thyroidectomy.
Abboud
Bassam
B
Department of General Surgery, Hotel-Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon. dbabboud@yahoo.fr
Sleilaty
Ghassan
G
Zeineddine
Salam
S
Braidy
Carla
C
Aouad
Rony
R
Tohme
Cyril
C
Noun
Roger
R
Sarkis
Riad
R
D000284:Administration, Oral; D000328:Adult; D002136:Calcium, Dietary / Q000008:administration & dosage*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology / Q000517:prevention & control*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010280:Parathyroid Glands / Q000637:transplantation*; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage*
D002136:Calcium, Dietary; D014807:Vitamin D