Routine postoperative administration of vitamin D and calcium after total thyroidectomy: a meta-analysis

BACKGROUND: Temporary hypocalcemia is a frequent complication after total thyroidectomy. Routine postoperative administration of vitamin D and calcium can reduce the incidence of symptomatic postoperative hypocalcemia. We undertook a systematic review to assess the effectiveness of this intervention. METHODS: We identified randomized controlled trials comparing the administration of vitamin D or metabolites to oral calcium or no treatment in patients after total thyroidectomy in MEDLINE, EMBASE and LILACS databases. RESULTS: Four studies with 706 patients were included: 346 in the calcitriol group, 288 in the oral calcium group and 72 in the control group. The rates of hypocalcemia symptoms were 4%, 19% and 31%, respectively. The OR value for the comparison between calcitriol + calcium as compared to no treatment and to exclusive calcium treatment groups was 0.32 (95% CI, 0.13-0.79) and 0.31 (95% CI, 0.14-0.70), respectively. CONCLUSION: The prophylactic treatment with vitamin D or metabolites + calcium is effective to decrease the incidence of symptoms of temporary hypocalcemia.