Abstract

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.