A Clinical Prospective Study of Hypocalcaemia Following Thyroid Surgery.

ABSTRACT

Background: Hypocalcaemia is one of the acute and most feared complication following thyroidectomy. Depending upon the extent of parathyroid damage, post-operative hypocalcaemia may be temporary or permanent requiring lifelong calcium supplements. Aims and objectives: This study aims to prospectively study and analyse the demographics and possible causes of hypocalcaemia post thyroidectomy.Methods: This is a prospective study of 150 patients undergoing thyroidectomy surgery from January 2015 to December 2015 in Victoria hospital, Bangalore medical college and research institute, Bangalore. Patients demographics, intra operative and pathological aspects were correlated to our hypocalcaemic findings.Results: Out of 150 patients, 18 patients developed temporary hypocalcaemia (12%), none of them developed permanent hypocalcaemia. Mean age of patients developing hypocalcaemia was 45.16 years. 15 (83.33%) of them were females and 3 (16.66%) were male. Hypocalcaemia was found in 9% in multinodular goitre (9 out of 99 patients), 20% in papillary carcinoma (3 out of 15 patients) and 40 % in follicular neoplasm (6 out of 15 patients). Near total thyroidectomy was the procedure in 105(70%) patients, 3 from them (2.86%) developed hypocalcaemia and the other 15 out of 45 cases (30%) were after total thyroidectomy. Mean duration of surgery was 101 mins. Average no of parathyroid glands identified was 2. Conclusion: Risk factor for development of hypocalcaemia is multifactorial. The recommended surgical strategy is meticulous dissection and preservation of at least one parathyroid gland and their blood supply to prevent permanent hypocalcaemia.