HIPOCALCEMIA POSTERIOR A LA CIRUGÌA TIROIDEA.

Abstract

Hypocalcemia following thyroid surgery Postoperative hypocalcemia is a common event after extensive thyroid surgery. It may reveal iatrogenic injury to the parathyroid glands and permanent hypoparathyroidism. We prospectively evaluated the incidence of hypocalcemia and permanent hypoparathyroidism following total o subtotal thyroidectomy in 535 consecutive patients operated in the period 1984-1999. We determined what early clinical and biochemical characteristics of patients experiencing postoperative hypocalcemia correlated with the long-term outcome. Postoperative calcemia lower than 2 mmol/dl was observed in 29 patients. In 20 patients hypocalcemia was considerer severe. Six months after surgery, 0.5% had persistent hypocalcemia. Patients carried a high risk for permanent hypoparathyroidism if fewer than three parathyroid glands were preserved in situ during surgery or the early serum parathyroid hormone level was = or > 12 pg/ml, the delayed serum calcium levels = or 4 mg/dl under oral calcium therapy .When one or more of these criteria are present, long-term follow-up should be enforced to check chronic hypocalcemia and to avoid its severe complications by appropriate supplement