Study of serum calcium level after thyroidectomy

Vildan Türkeli, Study Of Serum Calcium Level After Thyroidectomy, SpecialityThesis, Bolu, 2008. Thyroid diseases is the leading course of endocrinology thatmust be dissolved in Turkey and in the World. Thyroidectomy is the most favorableoption for patients who have thyrotoxicosis, suspicion of malignancy and patientswith pressure symptoms. Mortality due to thyroidectomy is considered nearly zeroby the most centers with contributions of Theodor Kocher to modern technique.Hypocalcemia due to thyroidectomy is a problem for patient, whilepostoperative follow up for surgeon, elongation of hospitalisation, laboratorystudyings, calcium and vitamin D usage, financial problem for both hospital andcountry.The aim of present study is to examine the association between symptomsand hypocalcemia that occur pre-intra and postoperative period of thyroid operations.By the determination of the factors, precautions can be achieved so one of the majorcomplications of thyroidectomy decline seriously.Totally 111 patients (30; male: 81; female) from AİBU General SurgeryDepartment who underwent to thyroidectomy with approprite indications areincluded to the study. Alkalin phosphatase, albumin, thyroid hormon status,placement of thyroid, biopsies are studied preoperatively, the technique ofthyroidectomy, cohesiveness of thyroid to the adjacent tissues, incidentalparathyroidectomy and parathyroid autotransplantion were assessed perioperativelyand symptomatic and/or biochemically hypocalcemia were assessed postoperatively.Female gender (p=0,032) and hyperthyroidism (p=0,031) were found to beindependent risk factors like for hypocalcemia due to thyroidectomy.At addition several factors play rol in the postthyroidectomy hypocalcemia.Especially permanent hypocalcemia can be prevented by accurate dissection withknowledge of parathyroid anatomy and location; when parathyroid perfusion defectwas suspected, proper parathyroid autotransplantation must be performed.Hypocalcemia must be keep in mind although in the exprerienced hands whenintrathyroidal placement is exist.Key words: Thyroidectomy, Hypocalsemia, Surgical Complication,Parathyroidectomy, Thyroid Diseases