Prophylactic vs On-demand Calcium Supplementation after Total Thyroidectomy: A Cohort Study Evaluating Two Different Protocols

World Journal of Endocrine Surgery, vol. 17, pp. 1–7

Abstract

IntroductIonPostoperative hypocalcemia resulting from parathyroid dysfunction is the most frequent complication following completion or total thyroidectomy (TT, completion thyroidectomy = a TT performed in multiple sessions), with an incidence between 3 and 64% depending on the definition used. 1 This condition is the result of either inadvertent removal or compromised vascularization of the anatomically related parathyroid glands and is treatable with calcium and/or active vitamin D supplementation.Patients with postoperative hypocalcemia often are hospitalized for a prolonged duration, leading to increased health care costs.Furthermore, postoperative hypocalcemia seems to be a risk factor for persistent hypoparathyroidism, which necessitates extended periods of supplementation and is associated with a reduction in quality of life.[2][3][4] Post-T T supplementation protocols can be broadly categorized as either prophylactic (proactive) or on-demand (reactive).Proactive protocols involve routine supplementation for all patients to prevent postoperative hypocalcemia and facilitate early discharge, thus reducing healthcare costs.[5][6][7][8][9][10]

Authors 6

1. Abbey Schepers Aachen Department of Endocrine Surgery

   Leiden University Medical Center

   Affiliation as printed

   Department of Endocrine Surgery , Leiden University Medical Center , Leiden , South Holland , Netherlands

2. Jaimie L. H. Zhang Aachen Department of Endocrine Surgery

   Leiden University Medical Center

   Affiliation as printed

   Department of Endocrine Surgery , Leiden University Medical Center , Leiden , South Holland , Netherlands,

3. Caroline M J van Kinschot Aachen Department of Endocrine Surgery

   Leiden University Medical Center

   Affiliation as printed

   ,

   Department of Endocrine Surgery , Leiden University Medical Center , Leiden , South Holland , Netherlands,

4. Natasha M. Appelman‐Dijkstra Aachen Department of Internal Medicine Division Endocrinology

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Internal Medicine Division Endocrinology , Leiden University Medical Center , Leiden , South Holland , Netherlands

5. Robin Patrick Peeters

   Erasmus MC · Erasmus MC Cancer Institute

   Affiliation as printed

   Department of Internal Medicine and Thyroid Diseases , Erasmus MC Cancer Institute University Medical Center , Rotterdam , South Holland , Netherlands

6. Tessa Malaika van Ginhoven

   Erasmus MC · Erasmus MC Cancer Institute

   Affiliation as printed

   Department of Surgical Oncology and Gastrointestinal Surgery , Erasmus MC Cancer Institute University Medical Center , Rotterdam , South Holland , Netherlands