Is therapy with calcium and vitamin D and parathyroid autotransplantation useful in total thyroidectomy for preventing hypocalcemia?

Head Neck. 2008 Sep;30(9):1148-54; discussion 1154-5. doi: 10.1002/hed.20836.

Abstract

Background: Routine calcium and vitamin D administration and routine autotransplantation of parathyroid glands can prevent hypocalcemia after total thyroidectomy.

Methods: Routine autotransplantation of 1 or more parathyroid glands and oral calcium and vitamin D supplementation was used in 252 patients.

Results: One, 2, or 3 parathyroid glands were autotransplanted in 223, 27, and 2 patients, respectively. Routine oral calcium and vitamin D was administered in postoperative period in all patients. Postoperative hypocalcemia occurred in 17%, of whom 1.6% had minor symptoms related to hypocalcemia. No patient developed permanent hypocalcemia during the follow-up period. The postoperative stay was 1 day in 93.6% of the cases. The incidence of postoperative hypocalcemia and hospital stay was higher in patients who underwent autotransplantation of more than 1 parathyroid gland.

Conclusions: Routine oral calcium and vitamin D supplementation and autotransplantation of at least 1 parathyroid gland effectively reduced symptomatic hypocalcemia and permanent hypoparathyroidism in total thyroidectomy.

MeSH terms

  • Administration, Oral
  • Adult
  • Calcium, Dietary / administration & dosage*
  • Case-Control Studies
  • Chi-Square Distribution
  • Combined Modality Therapy
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Hypocalcemia / etiology
  • Hypocalcemia / prevention & control*
  • Length of Stay
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Parathyroid Glands / transplantation*
  • Postoperative Care / methods
  • Retrospective Studies
  • Risk Assessment
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery
  • Thyroidectomy / adverse effects*
  • Transplantation, Autologous
  • Treatment Outcome
  • Vitamin D / administration & dosage*

Substances

  • Calcium, Dietary
  • Vitamin D