Study of the incidence of hypocalcemia in patients undergoing bilateral thyroid surgery

Background: Thyroid surgery are among the most common operations performed all over the world. Hypocalcemia following total thyroidectomy is a fairly common complication. Occurrence of acute hypocalcemia can be predicted in patients undergoing thyroid surgery, based on serial calcium measurement and this helps in early prediction of hypocalcemia. The aim of present study was to assess the incidence of post thyroidectomy hypocalcemia and factors which might play a role in its occurrence.Methods: A total 30 patients who underwent bilateral thyroidectomy were analysed. The study period was from June 2017 to March 2019. The incidence of hypocalcemia was analysed with serial calcium estimation in immediate post-operative period, 4 hours and 24 hours after surgery and on 5th post-operative day. The factors analysed included pre-operative and post-operative serum calcium levels, clinical features, the disease type and factors related to surgery. The ethical approval was taken from the ethical committee of the institute. At the end of the study data was collected and analysed by using student t-test and chi square test. A p-value of less than 0.05 was considered significant.Results: Post-operative transient hypocalcemia developed in 21 patients out of 30 (70%). Of them six patients (28.75%) developed severe hypocalcemia and 15 (71.42%) developed mild to moderate hypocalcemia. Out of six patients, five patients were histopathologically diagnosed as malignant thyroid disease. 15 patients who developed mild to moderate hypocalcemia were diagnosed to be having benign thyroid conditions.Conclusions: Patients underwent thyroid surgery for malignant conditions showed higher incidence and severity hypocalcemia as compared to cases where surgery was performed for benign thyroid disease. This complication can be prevented with meticulous perioperative dissection, prompt identification of parathyroid glands and frequent postoperative monitoring of serum calcium levels.