38501
document
Prevention of postoperative hypocalcemia with routine oral calcium and vitamin D supplements in patients with differentiated papillary thyroid carcinoma undergoing total thyroidectomy plus central neck dissection . BACKGROUND Routine oral calcium and vitamin D supplementation may prevent hypocalcemic crisis , but its efficacy has not been studied in patients undergoing thyroidectomy plus central neck dissection ( CND ) . The authors therefore prospectively evaluated the clinical usefulness of routine oral calcium and vitamin D supplementation for prevention of hypocalcemia after total thyroidectomy and CND . METHODS Of 197 patients with differentiated papillary thyroid carcinoma , 49 underwent total thyroidectomy alone , and 148 underwent total thyroidectomy plus CND . The latter were randomized to oral calcium ( 3 g/day ) plus vitamin D ( 1 mg/day ) ( Group A , n=49 ) , calcium alone ( Group B , n=49 ) , or no supplements ( Group C , n=50 ) . Hypocalcemic symptoms , serum calcium , and parathyroid hormone ( PTH ) levels were compared among the groups . RESULTS Group C had significantly higher incidences of symptomatic ( 26.0 % vs 6.1 % ; P < .015 ) and laboratory ( 44.0 % vs 14.3 % ; P < .015 ) hypocalcemia than the group without CND . The incidences of symptomatic and laboratory hypocalcemia were significantly decreased in Groups A ( 2.0 % and 8.2 % , respectively ) and B ( 12.2 % and 24.5 % , respectively ) ( P < .05 ) . Serum calcium levels decreased in most patients after surgery , but recovered earliest in Group A. Hypercalcemia and PTH inhibition did not occur in gs A and B . CONCLUSIONS Compared with total thyroidectomy alone , CND significantly increases the rate of postoperative hypocalcemia , which can be prevented by routine postoperative supplementation with oral calcium and vitamin D .
38502
Intervention_Pharmacological
calcium
38503
Intervention_Pharmacological
vitamin D supplements
38504
Intervention_Pharmacological
oral calcium
38505
Intervention_Pharmacological
vitamin D supplementation
38506
Intervention_Pharmacological
total thyroidectomy plus CND
38507
Intervention_Pharmacological
oral calcium
38508
Intervention_Pharmacological
vitamin D
38509
Intervention_Pharmacological
calcium alone
38510
Outcome_Physical
Hypocalcemic symptoms , serum calcium , and parathyroid hormone ( PTH ) levels
38511
Outcome_Physical
hypocalcemia
38512
Outcome_Physical
symptomatic and laboratory hypocalcemia
38513
Outcome_Physical
Serum calcium levels
38514
Outcome_Physical
postoperative hypocalcemia