Routine postoperative administration of vitamin D and calcium after total thyroidectomy: a meta-analysis.
BACKGROUND
Temporary hypocalcemia is a frequent complication after total thyroidectomy. Routine postoperative administration of vitamin D and calcium can reduce the incidence of symptomatic postoperative hypocalcemia. We undertook a systematic review to assess the effectiveness of this intervention.


METHODS
We identified randomized controlled trials comparing the administration of vitamin D or metabolites to oral calcium or no treatment in patients after total thyroidectomy in MEDLINE, EMBASE and LILACS databases.


RESULTS
Four studies with 706 patients were included: 346 in the calcitriol group, 288 in the oral calcium group and 72 in the control group. The rates of hypocalcemia symptoms were 4%, 19% and 31%, respectively. The OR value for the comparison between calcitriol + calcium as compared to no treatment and to exclusive calcium treatment groups was 0.32 (95% CI, 0.13-0.79) and 0.31 (95% CI, 0.14-0.70), respectively.


CONCLUSIONS
The prophylactic treatment with vitamin D or metabolites + calcium is effective to decrease the incidence of symptoms of temporary hypocalcemia.
Sanabria
Alvaro
A
Department of Surgery, School of Medicine, Universidad de La Sabana, Bogota, Campus Puente del Comun, Km 21 Autopista Norte, Chia, Colombia. alvarosanabria@gmail.com
Dominguez
Luis C
LC
Vega
Valentin
V
Osorio
Camilo
C
Duarte
Daniel
D
D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D002136:Calcium, Dietary / Q000008:administration & dosage*; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology / Q000517:prevention & control*; D011182:Postoperative Care; D013965:Thyroidectomy / Q000009:adverse effects*; D014807:Vitamin D / Q000008:administration & dosage*
D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary; D014807:Vitamin D