title: Does near total thyroidectomy offer advantage over total thyroidectomy in terms of postoperative hypocalcemia?
abstract: Total thyroidectomy (TT) has emerged as a surgical option in the surgical treatment of patients with multinodular goiter. TT carries potential risk to all parathyroid glands and both recurrent laryngeal nerve. The aims of this study are to evaluate the difference between serum calcium levels before and after total and near total thyroidectomy and to compare the rate of postoperative hypocalcemia according to surgical procedures. This prospective study included 143 consecutive patients undergoing surgical therapy for non-toxic multinodular goiter. Patients were randomly assigned to surgical procedures. Patients in group 1 (n=75) performed TT, and patients in group 2 (n=68) performed near total thyroidectomy (NTT). The difference between serum calcium levels and percentage decrease in serum calcium levels before and after thyroidectomy were calculated. TT had a 33-fold (OR: 33.1; 95% CI: 7.5-145.02) increased risk for hypocalcemia. Moreover, TT had a 8-fold (OR: 8.09; 95% CI: 3-21.4) and a 27-fold (OR: 27.9; 95% CI: 3.5-219.6) higher risk than NTT for moderate and severe percentage decreases in serum calcium level, respectively. NTT can offer an advantage over TT in terms of postoperative hypocalcemia in the patients with benign multinodular goiter.
authors.affiliation: Ataturk Training and Research Hospital, General Surgery Clinic, Izmir, Turkey. drhru@mynet.com
authors.forename: Haluk Recai
authors.initials: HR
authors.lastname: Unalp
authors.forename: Yesim
authors.initials: Y
authors.lastname: Erbil
authors.forename: Taner
authors.initials: T
authors.lastname: Akguner
authors.forename: Erdinç
authors.initials: E
authors.lastname: Kamer
authors.forename: Hayrullah
authors.initials: H
authors.lastname: Derici
authors.forename: Halim
authors.initials: H
authors.lastname: Issever
mesh_terms: D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D005260:Female; D006044:Goiter, Nodular / Q000601:surgery*; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods; D055815:Young Adult
chemical_list: D002118:Calcium