Research Article
Volume 5 Issue 4 - 2021
Is ‘Preoperative Vitamin-D Deranged Level’ the Causative Element for Postoperative Hypocalcemia among Women Following Total/Completion Thyroidectomy?
Hurtamina Khan1*, S M Tariq Rafi2, Shireen AA Ramazanali3 and Sameer Queshi4
1Assistant Professor, ENT and Head and Neck Surgery, Jinnah Postgraduate Medical Centre/Jinnah Sindh Medical University, JPMC, Karachi, Pakistan
2Professor of ENT, Vice Chancellor, Jinnah Sindh Medical University, Karachi, Pakistan
3Assistant Professor, General Surgery Department, HOD Medical Education and Skill Labs, Sir Syed Medical College, Karachi, Pakistan
4Professor of ENT, HOD/Jinnah Postgraduate Medical Centre, Karachi, Pakistan
*Corresponding Author: Hurtamina Khan, Assistant Professor, ENT and Head and Neck Surgery, Jinnah Postgraduate Medical Centre/ Jinnah Sindh Medical University, JPMC, Karachi, Pakistan.
Received: February 23, 2021; Published: March 31, 2021


Background: Vitamin-D deficiency/insufficiency is the etiological-factor for postoperative hypocalcemia following total thyroidectomy among females reported in a tertiary care hospital.

Objective: The objective is to investigate vitamin-D levels preoperatively as a screening procedure to avoid postoperative hypocalcemia risk and complication.

Design and Setting: A 04 years retrospective review of prospectively collected data of patients who developed hypocalcemia following total- thyroidectomy or completion-thyroidectomy between January 2019 - June 2020 (n = 40) was performed and study conducted in the department of ENT/Head n Neck Surgery at Jinnah Postgraduate Medical Center Hospital Karachi.

Methodology: Total thyroidectomy was performed in all 40 cases which were diagnosed as benign and malignant tumour of thyroid gland. 06 cases out of 40, in which selective neck dissection was done in diagnosed papillary CA thyroid. Inclusion criteria: Age 20 - 50 years, gender female, patients with euthyroid status, serum calcium normal in range. Exclusion criteria: Above 50 years, gender male, patients with evidence of hyper/hypothyroidism were excluded from the study.

Result: Measured all patients pre-operative serum calcium levels were normal though postoperatively serum calcium in 10 cases (25%) were deranged. 10 patients/total n = 40 with serum calcium low levels in which 05 patients symptoms were positive and 05 patients were symptom free. Inj Calcium gluconate was administrated postoperatively but when the symptoms were not get relieved than, Vitamin-D levels were measured (postoperatively) in all patients who had or had not positive symptoms. Postoperatively vitamin-D deficiency reported in 18 patients out of 40 patients, out of these 18 patients 12 patients presented with symptoms and 02 patients with low levels of vitamin-d, had no symptoms.

Conclusion: We recommend to get investigate and preoperative measurement of vitamin-D levels as a screening lab and in case of deranged levels, administration of vitamin- D for correction in all patients of thyroid surgical procedure to reduce the health burden by avoiding long stay at hospital, repeated and multiple blood investigations and finally, financial loss of patients following thyroidectomy and deranged levels of vitamin-D should be corrected preoperatively to avoid postoperative hypocalcemia. Patients with vitamin D deficiency if get Vitamin D replacement before the procedure might enhance outcomes after procedure.


Keywords: Total Thyroidectomy; Postoperative Hypocalcemia; Vitamin D Deficiency; Calcium Gluconate


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Citation: Hurtamina Khan., et al. “Is ‘Preoperative Vitamin-D Deranged Level’ the Causative Element for Postoperative Hypocalcemia among Women Following Total/Completion Thyroidectomy?”. EC Emergency Medicine and Critical Care 5.4 (2021): 128-133.

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