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Impact of pre-operative serum 25-hydroxyvitamin D on post-operative serum calcium in patients undergoing total thyroidectomy for benign goitre: retrospective study of 246 patients

Published online by Cambridge University Press:  06 September 2017

M Erlem ,
N Klopp-Dutote ,
A Biet-Hornstein ,
V Strunski  and
C Page
M Erlem
Affiliation:
Department of ENT and Head and Neck Surgery, University Hospital, Amiens, France
N Klopp-Dutote
Affiliation:
Department of ENT and Head and Neck Surgery, University Hospital, Amiens, France
A Biet-Hornstein
Affiliation:
Department of ENT and Head and Neck Surgery, University Hospital, Amiens, France
V Strunski
Affiliation:
Department of ENT and Head and Neck Surgery, University Hospital, Amiens, France
C Page*
Affiliation:
Department of ENT and Head and Neck Surgery, University Hospital, Amiens, France
*
Address for correspondence: Dr Cyril Page, Service d'ORL et de chirurgie de la face et du cou, Centre Hospitalier Sud, 80054 Amiens Cedex, France E-mail: [email protected]
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Abstract

Objective:

To determine whether pre-operative serum 25-hydroxyvitamin D has an impact on post-operative parathyroid hormone and serum calcium levels in patients undergoing total thyroidectomy for benign goitre.

Methods:

This single-centre, retrospective study comprised 246 unselected surgical patients who had undergone total thyroidectomy for bilateral, benign, multinodular goitre. The correlation between pre-operative serum 25-hydroxyvitamin D and post-operative serum parathyroid hormone and serum calcium was studied to determine whether low pre-operative serum 25-hydroxyvitamin D was predictive of post-operative hypocalcaemia.

Results:

Seventy-nine patients (32 per cent) had post-operative hypocalcaemia. Eighteen patients (7.32 per cent) experienced unintentional parathyroidectomy (1 parathyroid gland in 15 patients, 2 parathyroid glands in 3 patients). In univariate analysis, pre-operative serum 25-hydroxyvitamin D was not correlated with post-operative serum calcium (p = 0.69) or post-operative serum parathyroid hormone (p = 0.5804). Furthermore, in multivariate analysis, which took into account unintentional parathyroidectomy, no correlation was found (p = 0.33). Bilateral unintentional parathyroidectomy was statistically associated with post-operative hypocalcaemia (p = 0.032).

Conclusion:

Pre-operative serum 25-hydroxyvitamin D did not appear to have any impact on post-operative serum calcium in patients undergoing total thyroidectomy for benign goitre.

Keywords

ThyroidectomyHypocalcemiaHypoparathyroidismVitamin DParathyroid Hormone
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 10 , October 2017 , pp. 925 - 929
Copyright
Copyright © JLO (1984) Limited 2017 

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References

1 Page, C, Strunski, V. Parathyroid risk in total thyroidectomy for bilateral, benign, multinodular goitre: report of 351 surgical cases. J Laryngol Otol 2007;121:237–41CrossRefGoogle ScholarPubMed
2 Noureldine, SI, Genther, DJ, Lopez, M, Agrawal, N, Tufano, RP. Early predictors of hypocalcemia after total thyroidectomy: an analysis of 304 patients using a short-stay monitoring protocol. JAMA Otolaryngol Head Neck Surg 2014;140:1006–13Google Scholar
3 Hessman, C, Fields, J, Schuman, E. Outpatient thyroidectomy: is it a safe and reasonable option? Am J Surg 2011;201:565–8CrossRefGoogle ScholarPubMed
4 Snyder, SK, Hamid, KS, Roberson, CR, Rai, SS, Bossen, AC, Luh, JH et al. Outpatient thyroidectomy is safe and reasonable: experience with more than 1,000 planned outpatient procedures. J Am Coll Surg 2010;210:575–82, 582–4CrossRefGoogle Scholar
5 Tripathi, M, Karwasra, RK, Parshad, S. Effect of preoperative vitamin D deficiency on postoperative hypocalcemia after thyroid surgery. Thyroid Res 2014;7:8 Google Scholar
6 Al-Khatib, T, Althubaiti, AM, Althubaiti, A, Mosli, HH, Alwasiah, RO, Badawood, LM. Severe vitamin D deficiency: a significant predictor of early hypocalcemia after total thyroidectomy. Otolaryngol Head Neck Surg 2015;152:424–31Google Scholar
7 Díez, M, Vera, C, Ratia, T, Diego, L, Mendoza, F, Guillamot, P et al. Effect of vitamin D deficiency on hypocalcaemia after total thyroidectomy due to benign goitre [in Spanish]. Cir Esp 2013;91:250–6CrossRefGoogle ScholarPubMed
8 Kirkby-Bott, J, Markogiannakis, H, Skandarajah, A, Cowan, M, Fleming, B, Palazzo, F. Preoperative vitamin D deficiency predicts postoperative hypocalcemia after total thyroidectomy. World J Surg 2011;35:324–30Google Scholar
9 Erbil, Y, Barbaros, U, Temel, B, Turkoglu, U, Işsever, H, Bozbora, A et al. The impact of age, vitamin D(3) level, and incidental parathyroidectomy on postoperative hypocalcemia after total or near total thyroidectomy. Am J Surg 2009;197:439–46Google Scholar
10 Erbil, Y, Bozbora, A, Ozbey, N, Issever, H, Aral, F, Ozarmagan, S et al. Predictive value of age and serum parathormone and vitamin D3 levels for postoperative hypocalcemia after total thyroidectomy for nontoxic multinodular goiter. Arch Surg 2007;142:1182–7Google Scholar
11 Yamashita, H, Noguchi, S, Murakami, T, Uchino, S, Watanabe, S, Ohshima, A et al. Predictive risk factors for postoperative tetany in female patients with Graves' disease. J Am Coll Surg 2001;192:465–8Google Scholar
12 Chia, SH, Weisman, RA, Tieu, D, Kelly, C, Dillmann, WH, Orloff, LA. Prospective study of perioperative factors predicting hypocalcemia after thyroid and parathyroid surgery. Arch Otolaryngol Head Neck Surg 2006;132:41–5Google Scholar
13 Falcone, TE, Stein, DJ, Jumaily, JS, Pearce, EN, Holick, MF, McAneny, DB et al. Correlating pre-operative vitamin D status with post-thyroidectomy hypocalcemia. Endocr Pract 2015;21:348–54Google Scholar
14 Lang, BH, Wong, KP, Cowling, BJ, Fong, YK, Chan, DK, Hung, GK. Do low preoperative vitamin D levels reduce the accuracy of quick parathyroid hormone in predicting postthyroidectomy hypocalcemia? Ann Surg Oncol 2013;20:739–45CrossRefGoogle ScholarPubMed
15 Salinger, EM, Moore, JT. Perioperative indicators of hypocalcemia in total thyroidectomy: the role of vitamin D and parathyroid hormone. Am J Surg 2013;206:876–82Google Scholar
16 Landry, CS, Grubbs, EG, Hernandez, M, Hu, MI, Hansen, MO, Lee, JE et al. Predictable criteria for selective, rather than routine, calcium supplementation following thyroidectomy. Arch Surg 2012;147:338–44Google Scholar
17 Griffin, TP, Murphy, MS, Sheahan, P. Vitamin D and risk of postoperative hypocalcemia after total thyroidectomy. JAMA Otolaryngol Head Neck Surg 2014;140:346–51Google Scholar
18 Lee, GH, Ku, YH, Kim, HI, Lee, MC, Kim, MJ. Vitamin D level is not a predictor of hypocalcemia after total thyroidectomy. Langenbecks Arch Surg 2015;400:617–22CrossRefGoogle Scholar
19 Docimo, G, Tolone, S, Pasquali, D, Conzo, G, D'Alessandro, A, Casalino, G et al. Role of pre and post-operative oral calcium and vitamin D supplements in prevention of hypocalcemia after total thyroidectomy. G Chir 2012;33:374–8Google ScholarPubMed
20 Nemade, SV, Rokade, VV, Pathak, NA, Tiwari, SS, Sonkhedkar, SJ. Comparison between perioperative treatment with calcium and with calcium and vitamin D in prevention of post thyroidectomy hypocalcemia. Indian J Otolaryngol Head Neck Surg 2014;66(suppl 1):214–19Google Scholar
21 Roh, JL, Park, CI. Routine oral calcium and vitamin D supplements for prevention of hypocalcemia after total thyroidectomy. Am J Surg 2006;192:675–8Google Scholar
22 Alhefdhi, A, Mazeh, H, Chen, H. Role of postoperative vitamin D and/or calcium routine supplementation in preventing hypocalcemia after thyroidectomy: a systematic review and meta-analysis. Oncologist 2013;18:533–42Google Scholar
23 Sanabria, A, Dominguez, LC, Vega, V, Osorio, C, Duarte, D. Routine postoperative administration of vitamin D and calcium after total thyroidectomy: a meta-analysis. Int J Surg 2011;9:46–51 Google Scholar
24 Wu, J, Harrison, B. Hypocalcemia after thyroidectomy: the need for improved definition. World Journal of Endocrine Surgery 2010;2:17–20 Google Scholar
25 Holick, MF, Binkley, NC, Bischoff-Ferrari, HA, Gordon, CM, Hanley, DA, Heaney, RP et al. Guidelines for preventing and treating vitamin D deficiency and insufficiency revisited. J Clin Endocrinol Metab 2012;97:1153–8Google Scholar
26 Geller, JL, Hu, B, Reed, S, Mirocha, J, Adams, JS. Increase in bone mass after correction of vitamin D insufficiency in bisphosphonate-treated patients. Endocr Pract 2008;14:293–7Google Scholar
27 Schöttker, B, Haug, U, Schomburg, L, Köhrle, J, Perna, L, Müller, H et al. Strong associations of 25-hydroxyvitamin D concentrations with all-cause, cardiovascular, cancer, and respiratory disease mortality in a large cohort study. Am J Clin Nutr 2013;97:782–93Google Scholar
28 Weaver, S, Doherty, DB, Jimenez, C, Perrier, ND. Peer-reviewed, evidence-based analysis of vitamin D and primary hyperparathyroidism. World J Surg 2009;33:2292–302Google Scholar
29 Durup, D, Jørgensen, HL, Christensen, J, Schwarz, P, Heegaard, AM, Lind, B. A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice: the CopD study. J Clin Endocrinol Metab 2012;97:2644–52Google Scholar
30 Durup, D, Jørgensen, HL, Christensen, J, Tjønneland, A, Olsen, A, Halkjær, J et al. A reverse J-shaped association between serum 25-hydroxyvitamin D and cardiovascular disease mortality: the CopD study. J Clin Endocrinol Metab 2015;100:2339–46Google Scholar
31 Sam, AH, Dhillo, WS, Donaldson, M, Meeran, K, Tolley, NS, Palazzo, FF. Serum parathyroid hormone is not an accurate predictor of postthyroidectomy hypocalcemia in vitamin D-deficient patients: a pilot study. Clin Chem 2011;57:1206–7CrossRefGoogle Scholar
32 Lang, BH, Wong, KP, Cheung, CY, Fong, YK, Chan, DK, Hung, GK. Does preoperative 25-hydroxyvitamin D status significantly affect the calcium kinetics after total thyroidectomy? World J Surg 2013;37:1592–8Google Scholar
33 Huang, SM. Do we overtreat post-thyroidectomy hypocalcemia? World J Surg 2012;36:1503–8Google Scholar