Hypocalcaemia after total thyroidectomy: incidence, control and treatment

Introduction: Hypocalcaemia, although usually transitory, is the most frequent complication after total thyroidectomy. Objective: To identify factors associated with a higher risk of hypoparathyroidism and related to aetiology and surgical procedure. Material and method: A total of 254 total thyroidectomies were analysed for the incidence of transitory or permanent hypocalcaemia based on the relationship with etiological and surgical factors. Results: Transient hypocalcaemia was present in 29.1% of the cases and permanent hypocalcemia was present in 4.7%. Postoperative hypocalcaemia was lower in patients with completion thyroidectomy than in patients that underwent total thyroidectomy in a single operation, 12% vs. 31%. Patients with Graves-Basedow disease developed postoperative hypocalcaemia in 50% of the cases. Mean recovery time of parathyroid function was 5.2 months, with 72.2% of the patients recovering before 6 months. Conclusions: Postoperative hypocalcaemia is a frequent complication of total thyroidectomy, but it is seldom permanent. Patients with Graves-Basedow disease have a higher incidence of postoperative hypocalcaemia and need closer follow-up. Postoperative calcium level analysis at 24 and 48 hours after surgery is not useful for rapid identification of patients at high risk of hypocalcaemia. (C) 2012 Elsevier Espana, S.L. All rights reserved.