Pre-operative calcium & vitamin D supplementation to prevent post-operative hypocalcaemia after total thyroidectomy

The Journal of Laryngology & Otology

Thyroidectomy is one of the most common interventions in general and endocrine surgery for patients with hyperthyroidism, goiter, thyroid nodules or thyroid cancer.

Post-operative hypocalcaemia is a recognized complication of thyroid surgery. The most common cause of acute symptomatic hypocalcemia in hospitalized patients is parathyroid gland disruption following total thyroidectomy and can result in prolonged hospital stay and increased hospital charges.

Key Points

Question: Does preoperative calcium and vitamin D supplementation decrease the incidence of hypocalcemia following total thyroidectomy?

Findings: In this study preoperative supplementation with calcium and calcitriol was associated with a reduced incidence of hypocalcemia following total thyroidectomy.

Conclusion: The use of routine prophylactic supplementation of calcium and vitamin D in the perioperative period can be useful in everyday clinical practice and may prevent postoperative hypocalcemia, allowing a safe and early discharge.

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Abstract

Objective

This systematic review aimed to establish the evidence behind the use of pre-operative calcium, vitamin D or both calcium and vitamin D to prevent post-operative hypocalcaemia in patients undergoing thyroidectomy.

Method

This review included prospective clinical trials on adult human patients that were published in English and which studied the effects of pre-operative supplementation with calcium, vitamin D or both calcium and vitamin D on the rate of post-operative hypocalcaemia following total thyroidectomy.

Results

Seven out of the nine trials included reported statistically significantly reduced rates of post-operative laboratory hypocalcaemia and symptomatic hypocalcaemia following pre-operative supplementation.

Conclusion

Pre-operative treatment with calcium, vitamin D or both calcium and vitamin D reduces the risk of post-operative hypocalcaemia and should be considered in patients undergoing total thyroidectomy.

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