European Journal of Molecular & Clinical Medicine

Background: Hypocalcaemia is a common complication following thyroid surgery,
cause of which is multifactorial. The aim of this study was to identify risk factors for
development of post-operative hypocalcaemia in cases of total thyroidectomy, near total
thyroidectomy, and completion thyroidectomy with or without neck dissection.
Materials and Methods: From 1st November 2020 to 31st October 2021, 40 consecutive
patients undergoing total thyroidectomy, near-total, sub-total or completion
thyroidectomy at Govt Medical College & Hospital, Suryapet were enrolled in this
prospective study, longitudinal, cohort study. The primary endpoints were the
occurrence of post-operative hypocalcaemia as by defined as a nadir corrected serum
calcium less than 8.0 mg/dL or symptomatic hypocalcaemia.
Results: 40 patients were analyzed. The average age was 42.53±15.86 years with 86.7%
female. The most common indications for surgery were benign thyroid disease (80%).
27 patients (67.5%) experienced postoperative hypocalcaemia with 14 (35 %) requiring
intravenous calcium infusion. Risk factors for postoperative hypocalcaemia included
inadvertent parathyroid removal during surgery further exemplified by the fact that
there is lesser incidence of post-operative hypocalcaemia in patients undergoing near
total thyroidectomy.
Conclusion: Patients undergoing total thyroidectomy and in whom parathyroid could
not be identified and preserved or auto transplanted may benefit from more vigilant
pre-operative preparation and postoperative calcium and vitamin D supplementation.

Background: Postoperative hypoparathyroidism manifesting as hypocalcaemia is still one of the most common complications seen in patients undergoing total thyroidectomy, despite every effort by the surgeon to preserve the parathyroid glands during surgery. Incidence varies from 0.5 to 65%(1). In the present study, we aimed to evaluate the role of serum Parathormone level as a reliable indicator of hypocalcaemia following total thyroidectomy. Material and Methods: Present study was a cross-sectional, observational study conducted in all the patients undergoing Total thyroidectomy at a tertiary hospital.
Results: In this study, the total number of patients included was 42. 90.5 % were female, and 9.5 % were male. In the present study, 57.1% (n=24) had benign disease, and 42.9 %(n=18) had malignant disease. The mean serum PTH value was 16.38 ± 7.70pg/dl among the benign group and 13.66 ± 5.40pg/dl in the malignant group. Serum PTH was lower among the malignant group than the benign group but was not statistically significant. The difference between pre-operative and post-operative values of corrected calcium levels was statistically significant. The correlation between the pre-operative and post-operative corrected calcium parameters showed a good positive correlation and is significant with a p-value of 0.007. The post-operative corrected calcium (<8mg/dl) and serum PTH (<15pg/m) showed a good positive correlation with significant p-value of
Conclusion: Serum PTH hormone levels should be evaluated for all the patients undergoing total thyroidectomy at 24 hours postoperatively, which is a reliable early predictor for patients who can develop hypocalcaemia even before serum calcium levels drop and hence predicting patients at risk of developing hypocalcaemia and treating them prophylactically.