Significance of Hypothyroidism in Post Thyroidectomy hypocalcaemi

Abstract

background: Postoperative hypocalcaemia is one of the most common complications of thyroid surgery.Objective: To evaluate the significance of thyrotoxicosis in developing hypocalcaemia after thyroid surgery.Patients and Methods: A prospective study for patients whom submitted to bilateral subtotal thyroidectomy in AL-Kadhimiya Teaching Hospital in the period from Mars 2006-Mars 2011 were included in this study. Patients were divided into two groups; in group A the patients had toxic goiter, while in group B, the patients had euthyroid goiter. Both groups are nearly identical for age, sex, size of the goiter, and the size of the removed thyroid tissue. All the operations were done by the same surgeon and same technique. At least 2 parathyroid glands are identified and carefully preserved in every patient. Serum calcium was measured before and after operation. Patients with malignant thyroid and those underwent lobectomy were excluded from this study.Results: The total number was 97 patients. Group A, include 24 patients, 10(41.6%) of them had transient hypocalcaemia and 5(20.8%) patients had permanent hypocalcaemia. One patient (4.1%) died eighteen months after the operation due to cardiomyopathy and heart failure.GroupB, include 73patients, 5(6.8%) of them had transient hypocalcemia.The relative risk of hypocalcaemia in toxic goiter is 3.53 (confidence interval 95%) in comparison with euthyroid goiter; P value <0.001which is very significant.Conclusion: Thyrotoxicosis is a significant risk factor in developing hypocalcaemia after thyroid surgery.