Background: Comparative studies among protocols for the management of post-total thyroidectomy (TT) hypocalcemia are lacking. We compared the effectiveness of PTH-driven selective supplementation (PD-SS) and routine calcium and calcitriol supplementation with preoperative calcitriol administration in preventing symptomatic hypocalcemia (SH) and readmission. Methods: Three-hundred consecutive patients undergoing TT were assigned to 3 groups: the PD-SS group, the high-dose routine supplementation (HD-RS) group and the low-dose routine supplementation (LD-RS) group. Results: Mean post-operative stay was shorter in HD-RS patients when compared to PD-SS and LD-RS (p < 0.001). Significantly more patients in the PD-SS group experienced SH (p = 0.042). The rate of post-operative hypocalcemia was not significantly different among the groups (p = 0.063). No readmission for SH or hypercalcemia occurred. Conclusions: HD-RS emerged as the most effective treatment to prevent SH, without increasing the risk of readmission for calcitriol-related hypercalcemia. Basing on the present results, HD-RS should be recommended as the preferable protocol.
Sessa, L., De Crea, C., Zotta, F., Pia Cerviere, M., Gallucci, P., Pennestri', F., Princi, P., Revelli, L., Arcuri, G., Bellantone, R. D. A., Raffaelli, M., Post-thyroidectomy hypocalcemia: Is a routine preferable over a selective supplementation?, <<THE AMERICAN JOURNAL OF SURGERY>>, 2021; 2021 (S0002-9610(21)00605-X): 1-6. [doi:10.1016/j.amjsurg.2021.10.015] [http://hdl.handle.net/10807/202103]
Post-thyroidectomy hypocalcemia: Is a routine preferable over a selective supplementation?
Sessa, LucaPrimo
;De Crea, CarmelaSecondo
;Zotta, Francesca;Gallucci, Pierpaolo;Pennestri', Francesco;Princi, Pietro;Revelli, Luca;Arcuri, Giovanni;Bellantone, Rocco Domenico AlfonsoPenultimo
;Raffaelli, MarcoUltimo
2021
Abstract
Background: Comparative studies among protocols for the management of post-total thyroidectomy (TT) hypocalcemia are lacking. We compared the effectiveness of PTH-driven selective supplementation (PD-SS) and routine calcium and calcitriol supplementation with preoperative calcitriol administration in preventing symptomatic hypocalcemia (SH) and readmission. Methods: Three-hundred consecutive patients undergoing TT were assigned to 3 groups: the PD-SS group, the high-dose routine supplementation (HD-RS) group and the low-dose routine supplementation (LD-RS) group. Results: Mean post-operative stay was shorter in HD-RS patients when compared to PD-SS and LD-RS (p < 0.001). Significantly more patients in the PD-SS group experienced SH (p = 0.042). The rate of post-operative hypocalcemia was not significantly different among the groups (p = 0.063). No readmission for SH or hypercalcemia occurred. Conclusions: HD-RS emerged as the most effective treatment to prevent SH, without increasing the risk of readmission for calcitriol-related hypercalcemia. Basing on the present results, HD-RS should be recommended as the preferable protocol.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.