Archives of medical science : AMS · 2021
Preoperative calcium and vitamin D supplementation may reduce postoperative hypocalcaemia after total thyroidectomy.
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Grzegory Anna, Pomorski Lech S, Pagacz Konrad, Sieniawski Karol, Kaczka Krzysztof
Аннотация
INTRODUCTION: Hypocalcaemia is the most common postoperative complication after total thyroidectomy. The purpose of the study was to evaluate the clinical usefulness of routine preoperative oral calcium and vitamin D supplementation in the prevention of hypocalcaemia after total thyroidectomy.
MATERIAL AND METHODS: One hundred and fifty-three consecutive patients with nontoxic multinodular goitre were randomly assigned to routinely receive (group B) or not receive (group A) calcium carbonate (3 g/day) and alfacalcidol (1 µg/day) on the day before surgery and calcium carbonate (1 g/day) and alfacalcidol (1 µg/day) taken once in the morning on the day of the operation. Their preoperative 25-hydroxyvitamin D (25-OHD) levels, hypocalcaemic symptoms, serum calcium and parathyroid hormone (iPTH) levels were determined 6 and 24 h and 6 weeks after surgery.
RESULTS: Symptomatic hypocalcaemia was observed in 41/153 (26.79%) patients. The incidence of symptomatic hypocalcaemia was significantly lower in the supplemented group than in the group not receiving supplementation: 10 of 77 participants (12.99%) versus 31 of 76 patients (40.79%) (p < 0.05). The rates of laboratory and severe hypocalcaemia (corrected calcium < 2.0 mmol/l) were 67.11% and 28.95% in group A and 50.65% and 9.09% in group B, respectively (p = 0.04, p < 0.05). There were no significant differences between groups A and B in corrected calcium levels after surgery and postoperative decreases in corrected calcium levels (p = 0.06). 112 (73.20%) participants had 25-OHD < 20 ng/ml. Vitamin D levels did not influence corrected calcium level changes (p = 0.98).
CONCLUSIONS: Oral supplementation with calcium and alfacalcidol may reduce post-thyroidectomy hypocalcaemia. Vitamin D deficiency was common among the study population.
MATERIAL AND METHODS: One hundred and fifty-three consecutive patients with nontoxic multinodular goitre were randomly assigned to routinely receive (group B) or not receive (group A) calcium carbonate (3 g/day) and alfacalcidol (1 µg/day) on the day before surgery and calcium carbonate (1 g/day) and alfacalcidol (1 µg/day) taken once in the morning on the day of the operation. Their preoperative 25-hydroxyvitamin D (25-OHD) levels, hypocalcaemic symptoms, serum calcium and parathyroid hormone (iPTH) levels were determined 6 and 24 h and 6 weeks after surgery.
RESULTS: Symptomatic hypocalcaemia was observed in 41/153 (26.79%) patients. The incidence of symptomatic hypocalcaemia was significantly lower in the supplemented group than in the group not receiving supplementation: 10 of 77 participants (12.99%) versus 31 of 76 patients (40.79%) (p < 0.05). The rates of laboratory and severe hypocalcaemia (corrected calcium < 2.0 mmol/l) were 67.11% and 28.95% in group A and 50.65% and 9.09% in group B, respectively (p = 0.04, p < 0.05). There were no significant differences between groups A and B in corrected calcium levels after surgery and postoperative decreases in corrected calcium levels (p = 0.06). 112 (73.20%) participants had 25-OHD < 20 ng/ml. Vitamin D levels did not influence corrected calcium level changes (p = 0.98).
CONCLUSIONS: Oral supplementation with calcium and alfacalcidol may reduce post-thyroidectomy hypocalcaemia. Vitamin D deficiency was common among the study population.