A comparative study of postoperative hypocalcaemia following total thyroidectomy in patients with Hashimoto’s thyroiditis and multinodular goitre in a rural tertiary care hospital

Authors

  • Amrutha P. Medical Student, MOSC Medical College, Kolenchery, Kerala, India
  • Arun P. Joseph Department of Surgery, MOSC Medical College, Kolenchery, Kerala, India
  • Anna Mathew Department of Pharmacology, MOSC Medical College, Kolenchery, Kerala, India
  • John Michael Raj Biostatistician, St. Johns Medical College, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20203253

Keywords:

Hashimoto’s thyroiditis, Hypocalcaemia, Multinodular goitre, Total thyroidectomy

Abstract

Background: Recurrent laryngeal nerve injury, hypothyroidism and hypocalcaemia have long been recognized as the three main sequalae of thyroidectomy. Persistent hypocalcaemia may cause intracranial lesions and cardiac arrhythmias. As the definitive diagnosis of Hashimoto’s thyroiditis was not always possible with clinical and cytological parameters when antibody testing was not done, surgery was planned with the diagnosis of multinodular goitre. This study was conducted to find out the incidence of post-operative hypocalcaemia following total thyroidectomy by skilled surgeons in patients with multinodular goitre and Hashimoto’s thyroiditis.

Methods: This was a cross-sectional study to compare the incidence of hypocalcaemia in patients with biopsy-proven Hashimoto’s thyroiditis and multinodular goitre. After obtaining approval from the institutional review board and ethics committee, data was collected serially, from the surgical records of 123 patients who underwent total thyroidectomy in this tertiary care centre, during the past two years.

Results: The incidence of post-operative hypocalcaemia (71.1%) in patients undergoing total thyroidectomy with Hashimoto’s thyroiditis was significantly higher than in patients with multinodular goitre (56.4%). Of the 45 patients who had a biopsy report of Hashimoto’s thyroiditis, 8 (17.8 %) developed permanent hypocalcaemia while only 8 (10.3%) of the 78 patients with histopathological diagnosis of multinodular goitre developed persistent hypocalcaemia needing supplementation following total thyroidectomy in this rural tertiary care hospital.

Conclusions: The significant risk of post-operative hypocalcaemia should be kept in mind before opting for total thyroidectomy for benign lesions of the thyroid and pre-operative antibody studies must be done to diagnose Hashimoto’s thyroiditis.

Author Biographies

Amrutha P., Medical Student, MOSC Medical College, Kolenchery, Kerala, India

Medical Student, MOSC Medical College, Kolenchery

Arun P. Joseph, Department of Surgery, MOSC Medical College, Kolenchery, Kerala, India

Assistant Professor, Department of Surgery, MOSC Medical College, Kolenchery

Anna Mathew, Department of Pharmacology, MOSC Medical College, Kolenchery, Kerala, India

Professor and HOD, Department of Pharmacology, MOSC Medical College, Kolenchery

John Michael Raj, Biostatistician, St. Johns Medical College, Bengaluru, Karnataka, India

Biostatistician, Department of Biostatistics, St. John's medicval College, Bangaluru, Karnataka

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Published

2020-07-23

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Original Research Articles