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ANALYSIS OF RISK OF SEVER HYPOCALCEMIA AFTER THYROIDECTOMY AMONG LOCAL POPULATION OF PAKISTAN

Muhammad Adil Shahzad, Muhammad Tahir Ismail, Iqra Qasim

Introduction: Hypocalcemia is one of the major complications of surgical interventions in the central neck (level VI) due to the small size of the parathyroid glands (PGs), their proximity and firm adherence to the thyroid, and the risk of compromising their blood flow during surgery. Aims and objectives: The basic aim of the study is to analyse the risk of sever hypocalcemia after thyroidectomy among local population of Pakistan. Material and methods: This cross sectional study was conducted in health department Punjab during April 2019 to January 2020. During surgery, all or partial thyroid tissue was removed, including the posterior capsule and pyramidal lobe, varying upon patient condition. All parathyroid glands were identified. The serum calcium and parathyroid hormone (PTH) level of patients were tested preoperatively and 48 hours after the operation, respectively. Results: Mean duration of hospital stay was 6.19 days (standard deviation 0.24), including one day prior to surgery. All patients had normal (9.5-75 pg/ml) pre-operative parathyroid hormone and normal calcium levels (8.0-10.4 mg/ dl). A total of 50 (50%) patients developed hypocalcemia (< 8.0 mg/dl) after surgery, of these 24 were symptomatic and 26 asymptomatic. Of the 24 patients who developed symptomatic hypocalcemia, 3 (12.5%) did so on the first day after surgery. Conclusion: It is concluded that postoperative hypocalcemia and hypoparathyroidism incidence were significantly related to the extent of thyroidectomy, gender, lateral lymph node dissection, operative time, and use of CNs.