American Association of Endocrine SurgeonsIs routine supplementation therapy (calcium and vitamin D) useful after total thyroidectomy?*
Section snippets
Material and methods
Patients who underwent total thyroidectomy between June and September 2001 were included in this study. Previous thyroid or neck operation or irradiation, substernal goiter, concomitant central or lateral neck lymph node dissection, and concomitant parathyroid diseases were considered as exclusion criteria. Patients who underwent video-assisted thyroidectomy were also excluded.
All eligible patients were asked to give their informed consent to be included in the study. The following parameters
Results
Seventy-nine patients were recruited for this study. Group A included 27 patients; groups B and C each had 26 patients. Patient characteristics for the 3 groups are summarized in the Table.The groups were well-matched as for age, sex, preoperative diagnosis, hormonal status, operative time, number of preserved parathyroid glands, and the final histology (Table). The PO stay was 3 days for all the patients because of the study protocol.
The rate of hypocalcemia was similar in group C (6 patients)
Discussion
During the last decade several authors reported the feasibility and safety of thyroid operation on an outpatient basis.13, 14, 15, 16 The possibility of symptomatic hypocalcemia still represents one of the major concerns after bilateral thyroid resection.11, 15, 16 Symptoms usually manifest 24 to 48 hours after operation.14 It is not usually possible to predict which patients are prone to have this complication develop, and thus require OC supplements, VD supplements, or both to avoid
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Reprint requests: Marco Raffaelli, MD, Divisione di Endocrinochirurgia, Istituto di Clinica Chirurgica, Dipartimento di Scienze Chirurgiche, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy.