Does preoperative vitamin D deficiency delay recovery time from transient hypocalcemia after thyroidectomy?

Yıl 2022, Cilt: 5 Sayı: 1, 114 - 118, 17.01.2022

Tezcan Akın Umut Fırat Turan Sadettin Er Sabri Özden Mesut Tez Barış Saylam

https://doi.org/10.32322/jhsm.1017305

Öz

Aim: To investigate the relationship between preoperative vitamin D deficiency and the recovery/healing time from postoperative hypoparathyroidism or hypocalcemia.
Material and Method: The sample consisted of patients that underwent thyroidectomy and preoperative 25-hydroxy-vitamin D analysis between 2014 and 2018 at the General Surgery Clinic of Health Sciences University Ankara Numune Training and Research Hospital. Of the 1598 patients who underwent total thyroidectomy, 73 were included in the study. These patients were selected from 214 patients who developed postoperative hypocalcemia. The patients’ demographic characteristics, surgical indications, operative findings, postoperative pathology results, preoperative and postoperative biochemical parameters and clinical outcomes were retrospectively obtained from the electronic records.
Results: Of the 73 patients included in the study, 10 (13.7%) were male and 63 (86.3%) were female. Preoperative vitamin D level was normal in 16 patients and deficient in 57. The patients were divided into two groups: Group 1 with normal preoperative vitamin-D levels and Group 2 with vitamin D deficiency. There was no statistically significant difference between Groups 1 and 2 in terms of parathormone (months 1, 2 and 3) and calcium levels (p>0.05); however, preoperative vitamin D levels statistically significantly differed between the two groups.
Conclusion: Our study suggests that having a normal level of vitamin D or deficiency does not have significant effect on the recovery time from hypocalcemia after thyroidectomy. Therefore, we consider that it is not necessary to measure vitamin D in routine preoperative screening or apply a vitamin D replacement.

Anahtar Kelimeler

Preoperative vitamin D level, transient hypocalcemia, postoperative parathormone level

Proje Numarası

yok

Kaynakça

• Roh JL, Park JY, Park CI. Prevention of postoperative hypocalcemia with routine oral calcium and vitamin D supplements in patients with differentiated papillary thyroid carcinoma undergoing total thyroidectomy plus central neck dissection. Cancer 2009; 115: 251-8.
• Al-Dhahri SF, Mubasher M, Mufarji K, Allam OS, Terkawi AS. Factors predicting post-thyroidectomy hypoparathyroidism recovery. World J Surg 2014; 38: 2304-10.
• Kim SM, Kim HK, Kim KJ, et al. Recovery from permanent hypoparathyroidism after total thyroidectomy. Thyroid 2015; 25: 830-3.
• Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002. Jama 2006; 295: 2164-7.
• Reeve T, Thompson NW. Complications of thyroid surgery: how to avoid them, how to manage them, and observations on their possible effect on the whole patient. World J Surg 2000; 24: 971-5.
• Atli T, Gullu S, Uysal A, Erdogan G. The prevalence of vitamin D deficiency and effects of ultraviolet light on vitamin D levels in elderly Turkish population. Arch Gerontol Geriatr 2005; 40: 53-60.
• Kirkby-Bott J, El-Khatib Z, Soudan B, Caiazzo R, Arnalsteen L, Carnaille B. 25-hydroxy vitamin D deficiency causes parathyroid incidentalomas. Langenbeck's Arch Surg 2010; 395: 919-24.
• Pattou F, Combemale F, Fabre S, et al. Hypocalcemia following thyroid surgery: incidence and prediction of outcome. World J Surg 1998; 22: 718-24.
• Singh G, Irshaidat F, Lau C, et al. Advancing the Understanding of Vitamin D Status in Post-Thyroidectomy Hypocalcemia. Int J Endocrinol 2021; 2021.
• Cherian AJ, Ponraj S, Ramakant P, Paul TV, Abraham DT, Paul M. The role of vitamin D in post-thyroidectomy hypocalcemia: Still an enigma. Surgery 2016; 159: 532-8.
• 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: 324-30.
• Yıldırım T. The frequency and relationship of osteoporosis and vitamin D deficiency in the female geriatric population in Central Anatolia. J Health Sci Med 2021; 4: 223-7.
• Celep G, Durmaz Z. Predicting vitamin D deficiency through parathormone in the children of a small city located in the warm climate belt of northern hemisphere. J Health Sci Med 2020; 3: 389-94.
• Vibhatavata P, Pisarnturakit P, Boonsripitayanon M, Pithuksurachai P, Plengvidhya N, Sirinvaravong S. Effect of preoperative vitamin D deficiency on hypocalcemia in patients with acute hypoparathyroidism after thyroidectomy. Int J Endocrinol 2020; 2020: 5162496.
• Taşkıran B, Cansu GB. Güneydoğu Bölgesinde erişkinlerde D vitamini eksikliği/vitamin D deficiency in adult residents of Southern Turkey. Osmangazi J Med 2016; 38.
• Lee GH, Ku YH, Kim HI, Lee M-C, Kim MJ. Vitamin D level is not a predictor of hypocalcemia after total thyroidectomy. Langenbeck's Arch Surg 2015; 400: 617-22.
• Rosato L, Avenia N, Bernante P, et al. Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg 2004; 28: 271-6.
• Erbil Y, Barbaros U, Temel B, et al. The impact of age, vitamin D3 level, and incidental parathyroidectomy on postoperative hypocalcemia after total or near total thyroidectomy. Am J Surg 2009; 197: 439-46.
• Gourgiotis S, Moustafellos P, Dimopoulos N, Papaxoinis G, Baratsis S, Hadjiyannakis E. Inadvertent parathyroidectomy during thyroid surgery: the incidence of a complication of thyroidectomy. Langenbeck's Arch Surg 2006; 391: 557-60.
• Lin DT, Patel SG, Shaha AR, Singh B, Shah JP. Incidence of inadvertent parathyroid removal during thyroidectomy. The Laryngoscope 2002; 112: 608-11.
• Griffin TP, Murphy MS, Sheahan P. Vitamin D and risk of postoperative hypocalcemia after total thyroidectomy. JAMA Otolaryngol Head Neck Surg 2014; 140: 346-51.
• Alkhalili E, Ehrhart MD, Ayoubieh H, Burge MR. Does pre-operative vitamin D deficiency predict postoperative hypocalcemia after thyroidectomy? Endocr Pract 2017; 23: 5-9.
• Hickey L, Gordon CM. Vitamin D deficiency: new perspectives on an old disease. Curr Opin Endocrinol Diabetes Obes 2004; 11: 18-25.
• Holick MF. Vitamin D deficiency. New Eng J Med 2007; 357: 266-81.
• Sitges‐Serra A, Ruiz S, Girvent M, Manjón H, Dueñas J, Sancho J. Outcome of protracted hypoparathyroidism after total thyroidectomy. Br J Surg 2010; 97: 1687-95.
• Edafe O, Balasubramanian SP. Incidence, prevalence and risk factors for post-surgical hypocalcaemia and hypoparathyroidism. Gland Surg 2017; 6: S59.
• Lang BH-H, Wong KP, Cheung CY, Fong YK, Chan DK-K, Hung GK-Y. Does preoperative 25-hydroxyvitamin D status significantly affect the calcium kinetics after total thyroidectomy? World J Surg 2013; 37: 1592-8.
• Vaitsi KD, Anagnostis P, Veneti S, Papavramidis TS, Goulis DG. Preoperative vitamin D deficiency is a risk factor for postthyroidectomy hypoparathyroidism: a systematic review and meta-analysis of observational studies. J Clin Endocrinol Metab 2021; 106: 1209-24.
• Ritter K, Elfenbein D, Schneider DF, Chen H, Sippel RS. Hypoparathyroidism after total thyroidectomy: incidence and resolution. J Surg Res 2015; 197: 348-53.