Abstract
TO STUDY THE INCIDENCE OF HYPOCALCAEMIA IN POST THYROIDECTOMY PATIENTS.

Dr. Prajawalam Rathod, Dr. D. D. Wagh*, Dr. H. Ramteke, Dr. Soni Singh

ABSTRACT

Background: Objective of the present study was to study the incidence of hypocalcaemia in post-thyroidectomy patients. Methods: Total 40 patients of thyroid swelling were studied prospectively from a period starting from july 2015 to april 2018 at a rural hospital, A.V.B.R.H. All patients visiting the surgical clinic with thyroid swelling and admitted for total thyroidectomy were included in the study. During the course of study, of the total patient who presented to the OPD,40 patients(male and female) were sorted out and were thoroughly examined clinically, hematologically, biochemically, sonologically and cytologically and were posted for total thyroidectomy. A serum calcium was sent preoperatively and on the first day of total thyroidectomy. Symptomatic hypocalcaemia developing within 24 hours of surgery & which returned to normal with little or no treatment was termed as Transient hypocalacaemia. Those cases who showed decrease in serum calcium i.e ≤ 8 (despite of any obvious symptoms) were started on tablet calcium and were assessed in follow up. Results: Of the total 40 patients of total thyroidectomy, 25% had post thyroidectomy hypocalcaemia;40% were symptomatic and 60% were asymptomatic; 30% were diagnosed as medullary carcinoma, 20% as papillary carcinoma, 20% as lymphocytic thyroiditis, 20% as nodular goiter and 10% cases of follicular carcinoma; 80% received oral calcium supplementation and 20% received injectable calcium supplementation. Conclusion: Meticulous dissection of thyroid lobes and respecting the anatomy of Recurrent nerves and identification of both pairs of parathyroides, preserving their blood supply are key factors a surgeon should observe during surgery in order to reduce the incidence of post thyroidectomy hypocalcaemia.

Keywords: Thyroidectomy, Hypocalcaemia, Medullary Carcinoma, Papillary Carcinoma, Follicular Carcinoma, Thyroiditis, Parathyroids.


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