Key result
Preoperative calcium and vitamin D3 supplementation did not reduce overall postoperative hypocalcemia, but lowered it in the bilateral thyroidectomy subgroup (41.7% vs 65.9%, P<0.05).
Why the study?
The effects of preoperative calcium and activated vitamin D3 supplementation on post-thyroidectomy hypocalcemia and hypo-PTHemia were unclear.
Does preoperative oral calcium and activated vitamin D3 supplementation prevent post-thyroidectomy hypocalcemia and hypo-PTHemia in patients undergoing thyroidectomy?
RCT (n=209)
randomly divided
Does preoperative oral calcium and activated vitamin D3 supplementation prevent post-thyroidectomy hypocalcemia and hypo-PTHemia in patients undergoing thyroidectomy?
Short-term preoperative calcium and activated vitamin D3 supplementation reduces the incidence of postoperative hypocalcemia and length of stay specifically in patients undergoing bilateral thyroidectomy.
Preoperative supplementation showed no overall benefit but may reduce hypocalcemia after bilateral thyroidectomy; leaves open confirmation in dedicated trials.
Objective: The aim was to explore the effects of preoperative calcium and activated vitamin D3 supplementation on post-thyroidectomy hypocalcemia and hypo-parathyroid hormone-emia (hypo-PTHemia). Methods: A total of 209 patients were randomly divided into control group (CG) and experimental group (EG). Oral calcium and activated vitamin D3 supplementation were preoperatively administered to EG, whereas a placebo was administered to CG. Data on serum calcium, phosphorus, and PTH concentrations before operation, on postoperative day 1 (POPD1), at postoperative week 3 (POPW3), and on the length of postoperative hospitalization were collected. Results: The serum calcium, phosphorus, and PTH concentrations, as well as the incidence of postoperative hypocalcemia and hypo-PTHemia, did not significantly differ between EG and CG. Subgroup analysis revealed that the serum calcium concentrations of the experimental bilateral thyroidectomy subgroup (eBTS) on POPD1 and POPW3 were higher than that of the control bilateral thyroidectomy subgroup (cBTS) (P < 0.05); the reduction of serum calcium in eBTS on POPD1 and POPW3 was less than those in cBTS (P < 0.05). However, significant differences were not observed between the unilateral thyroidectomy subgroups (UTS) (P > 0.05). Moreover, the incidence of postoperative hypocalcemia in cBTS on POPD1 was significantly higher than that in eBTS (65.9% vs 41.7%) (P < 0.05). The length of hospitalization in cBTS (3.55 ± 1.89 days) was significantly longer than that (2.79 ± 1.15 days) in eBTS (P < 0.05). Conclusion: Short-term preoperative prophylactic oral calcium and activated vitamin D3 supplementation could effectively reduce the incidence of postoperative hypocalcemia and decrease the length of postoperative hospitalization in patients who have undergone bilateral thyroidectomy.
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Jin et al. (2023) conducted an RCT in Thyroidectomy (n=209). Preoperative oral calcium and activated vitamin D3 vs. Placebo was evaluated on Incidence of postoperative hypocalcemia and hypo-PTHemia. Preoperative calcium and vitamin D3 supplementation did not reduce overall postoperative hypocalcemia, but lowered it in the bilateral thyroidectomy subgroup (41.7% vs 65.9%, P<0.05).
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