Parthipan, G (2020) A Clinical study of Hypocalcemia following Total Thyroidectomy in Tertiary Care Centre. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
INTRODUCTION: Total Thyroidectomy is one of the most common endocrine surgeries. It is the treatment of choice for the patients with malignant thyroid tumors as well as patients with multinodular goiters who experience compression symptoms. The most common complication of total thyroidectomy is post-operative hypocalcemia due to hypoparathyroidism. This complication is relatively common with an incidence of 20% to 30%, perhaps due to the sensitivity of parathyroid glands and their supplying arteries to trauma during surgery. However, most cases of post-operative hypocalcemia are transient, and the rate of permanent hypocalcemia persisting 12 months after the surgery is less than 2%. AIM OF THE STUDY: To estimate the incidence of hypocalcemia following total thyroidectomy and to correlate hypocalcemic features with ionized calcium level. MATERIALS AND METHODS: The present study included 104 patients who underwent total or completion thyroidectomy in various surgical units from July 2017 to June 2019 in the Department of General Surgery, Tirunelveli Medical College Hospital, Tirunelveli. RESULTS: This study was performed in a series of 104 patients of which 97 were females and 7 males. Most commonly middle age group (30-50 years) were affected by thyroid diseases. Majority of patients had non toxic multi nodular goitre. Incidence of hypocalcemia following total thyroidectomy was 37%. Incidence of post op hypocalcemia was more common in Thyroid malignancy, Toxic goitre and Hashimoto’s thyroiditis. Post op hypocalcemia was commonly reported in third POD and they had perioral numbness as the most common symptom.Patient treated with oral or IV calcium supplementation according to the serum calcium levels and severity of hypocalcemia. CONCLUSION: This study concluded that transient hypocalcemia is the most common complication following total thyroidectomy. The incidence of post operative hypocalcemia is 36%. Proper planning and meticulous surgical techniques needed in localisation and preserve blood supply to the parathyroids by ligating the branches of inferior thyroid artery individually without any compromise in parathyroid blood supply especially in thyroid malignancy, toxic goitre and Hashimoto’s thyroiditis. Incidence of post operative hypocalcemia more in thyroid malignancy and toxic goitre. Pre and postop monitoring of serum calcium levels is essential for diagnosis, treatment and follow up of patients with hypocalcemia.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221711362 |
| Uncontrolled Keywords: | Hypocalcemia, Parathyroids, perioral numbness, carpopedal spasm, Hashimoto’s thyroiditis. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 11 Feb 2021 02:09 |
| Last Modified: | 11 Feb 2021 02:09 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14040 |
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