title: Randomized controlled trial of alfacalcidol supplementation for the reduction of hypocalcemia after total thyroidectomy.
abstract: BACKGROUND
  The aim of this study was to evaluate the effect of perioperative alfacalcidol on postoperative hypocalcemia after total thyroidectomy.
  
  
  METHODS
  A total of 219 patients scheduled for total thyroidectomy were randomized into groups not receiving (group A) or receiving (group B) perioperative alfacalcidol. Postoperative hypocalcemia was compared between groups on postoperative day (POD) 1 and POD2. Patients with hypocalcemia (<2.00 mmol/L) received oral calcium supplementation. Calcium and vitamin D levels were measured at 5-week and 6-month follow-ups.
  
  
  RESULTS
  The incidence of symptomatic hypocalcemia was significantly lower in group A (P = .02), whereas similarly low levels of calcemia were observed in both groups on POD1 (37% and 30%, respectively; P = not significant) and persisted on POD2 (14% and 6%, respectively; P = not significant). Patients with severe hypocalcemia (<1.90 mmol/L) showed faster recovery in group A compared with group B (6% vs 1%, P = .04). At 5 weeks, calcium and vitamin D levels were similar between the groups. Six months after surgery, 4% (group A) versus 0% (group B) of subjects exhibited permanent hypoparathyroidism (P = .04).
  
  
  CONCLUSIONS
  Although the treatment did not correct vitamin D deficiency, perioperative alfacalcidol uptake resulted in decreased transient hypocalcemia and related symptoms in patients undergoing total thyroidectomy.
authors.affiliation: Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Genser
authors.affiliation: Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Trésallet
authors.affiliation: Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Godiris-Petit
authors.affiliation: Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Li Sun Fui
authors.affiliation: Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France.
authors.forename: Harika
authors.initials: H
authors.lastname: Salepcioglu
authors.affiliation: Department of Anaesthesiology, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Royer
authors.affiliation: Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France. Electronic address: fabrice.menegaux@psl.aphp.fr.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Menegaux
mesh_terms: D000328:Adult; D000368:Aged; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006887:Hydroxycholecalciferols / Q000008:administration & dosage / Q000627:therapeutic use*; D006996:Hypocalcemia / Q000188:drug therapy* / Q000209:etiology*; D007011:Hypoparathyroidism / Q000209:etiology; D008297:Male; D008875:Middle Aged; D013965:Thyroidectomy / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000453:epidemiology / Q000209:etiology
chemical_list: D050071:Bone Density Conservation Agents; D006887:Hydroxycholecalciferols; D014807:Vitamin D; D002118:Calcium; C008088:alfacalcidol
keywords: Active vitamin D; Alfacalcidol; Hypocalcemia; Total thyroidectomy; Vitamin D