title: Prophylactic oral calcium supplementation therapy to prevent early post thyroidectomy hypocalcemia and evaluation of postoperative parathyroid hormone levels to detect hypocalcemia: A prospective randomized study.
abstract: BACKGROUND
  Postoperative hypocalcemia is the most common complication after total thyroidectomy. Postoperative parathyroid hormone (PTH) measurement is one of the methods to detect or prevent postoperative hypocalcemia. Prophylactic oral calcium supplementation is another method to prevent early postoperative hypocalcemia. The aim of this study is to detect the accurate timing of PTH and evaluate efficacy of routine oral calcium supplementation for postoperative hypocalcemia.
  
  
  METHODS
  A total of 106 patients were performed total thyroidectomy. Rotuine oral calcium supplementation was given to group 1 and no treatment to group 2 according to randomization. Serum calcium and PTH level of patients in group 2 at postoperative 6, 12 and 24 h and patients in both groups at postoperative day 7 were evaluated. Patients were compared according to age, sex, operation findings, serum calcium and PTH levels and symptomatic hypocalcemia.
  
  
  RESULTS
  Half of the patients (50%) were in group 1. Most of the patients were female (83%). The most common etiology of thyroid disease was multinodular goiter (64.1%). Oral calcium supplementation was given to 18 (33.9%) patients in group 2. Symptomatic hypocalcemia for group 1 and 2 was found to be 1.9 and 33.9% respectively (p < 0.05). No statistical difference can be observed regarding the timing of serum biomarkers.
  
  
  CONCLUSIONS
  Serum PTH levels at postoperative 12 and 24 h can predict early post-thyroidectomy hypocalcemia. Prophylactic oral calcium supplementation therapy can prevent early post-thyroidectomy hypocalcemia with advantages of being cost effective and safe.
authors.affiliation: Baskent University Adana Teaching and Research Center, Department of General Surgery, Adana, Turkey. Electronic address: igy1981@yahoo.com.
authors.forename: Ilker Murat
authors.initials: IM
authors.lastname: Arer
authors.affiliation: Baskent University Adana Teaching and Research Center, Department of General Surgery, Adana, Turkey. Electronic address: drmuratkus@gmail.com.
authors.forename: Murat
authors.initials: M
authors.lastname: Kus
authors.affiliation: Baskent University Adana Teaching and Research Center, Department of General Surgery, Adana, Turkey. Electronic address: akkapulu@gmail.com.
authors.forename: Nezih
authors.initials: N
authors.lastname: Akkapulu
authors.affiliation: Baskent University Adana Teaching and Research Center, Department of General Surgery, Adana, Turkey. Electronic address: oaytac@gmail.com.
authors.forename: Huseyin Ozgur
authors.initials: HO
authors.lastname: Aytac
authors.affiliation: Baskent University Adana Teaching and Research Center, Department of General Surgery, Adana, Turkey. Electronic address: drhyabanoglu@gmail.com.
authors.forename: Hakan
authors.initials: H
authors.lastname: Yabanoglu
authors.affiliation: Baskent University Adana Teaching and Research Center, Department of General Surgery, Adana, Turkey. Electronic address: ken_caliskan@yahoo.com.
authors.forename: Kenan
authors.initials: K
authors.lastname: Caliskan
authors.affiliation: Baskent University Adana Teaching and Research Center, Department of General Surgery, Adana, Turkey. Electronic address: eatarim@hotmail.com.
authors.forename: Mehmet Akin
authors.initials: MA
authors.lastname: Tarim
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000008:administration & dosage* / Q000097:blood; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control*; D011184:Postoperative Period; D011446:Prospective Studies; D013959:Thyroid Diseases / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects*
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D002118:Calcium
keywords: Calcium prophylaxis; Hypocalcemia; Oral calcium; Parathyroid hormone; Thyroidectomy