Is it possible to identify a risk factor condition of hypocalcemia in patients candidates to thyroidectomy for benign disease?

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COD: 06_2010_397-402 Categorie: ,

Paolo Del Rio, Gioacchino Iapichino, Belinda De Simone, Lamia Bezer, MariaFrancesca Arcuri, Mario Sianesi

Ann. Ital. Chir., 2010 81: 397-401

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AIM: Hypocalcaemia is the most frequent complication after total thyroidectomy. The incidence of postoperative hypocalcaemia
is reported with different percentages in literature.
METHODS: We report 227 patients undergoing surgery for benign thyroid disease. After obtaining patient’s informed consent,
we collected and analyzed prospectively the following data: calcium serum levels pre and postoperative in the first
24 hours after surgery according to sex, age, duration of surgery, number of parathyroids identified by the surgeon, surgical
technique (open and minimally invasive video-assisted thyroidectomy i.e. MIVAT). We have considered cases treated
consecutively from the same two experienced endocrine surgeons. Hypocalcaemia is assumed when the value of serum
calcium is below 7.5 mg / dL.
RESULTS: Pre-and post-operative mean serum calcium, with confidence intervals at 99% divided by sex, revealed a statistically
significant difference in the ANOVA test (p <0.01) in terms of incidence. Female sex has higher incidence of hypocalcemia. The evaluation of the mean serum calcium in pre-and post-operative period, with confidence intervals at 95%, depending on the number of identified parathyroid glands by surgeon, showed that the result is not correlated with values of postoperative serum calcium. Age and pre-and postoperative serum calcium values with confidence intervals at 99% based on sex of patients, didn’t show statistically significant differences. We haven’t highlighted a significant difference in postoperative hypocalcemia in patients treated with conventional thyroidectomy versus MIVAT. CONCLUSION: A difference in pre- and postoperative mean serum calcium occurs in all patients surgically treated. The only statistical meaningful risk factor for hypocalcemia has been the female sex.

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