Laurent Genser1, Christophe Trésallet1, Gaëlle Godiris-Petit1, Stéphanie Li Sun Fui1, Harika Salepcioglu1, Catherine Royer2, Fabrice Menegaux3. 1. Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France. 2. Department of Anaesthesiology, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, Paris, France. 3. Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France. Electronic address: fabrice.menegaux@psl.aphp.fr.
Abstract
BACKGROUND: The aim of this study was to evaluate the effect of perioperative alfacalcidol on postoperative hypocalcemia after total thyroidectomy. METHODS: A total of 219 patients scheduled for total thyroidectomy were randomized into groups not receiving (group A) or receiving (group B) perioperative alfacalcidol. Postoperative hypocalcemia was compared between groups on postoperative day (POD) 1 and POD2. Patients with hypocalcemia (<2.00 mmol/L) receivedoral calcium supplementation. Calcium and vitamin D levels were measured at 5-week and 6-month follow-ups. RESULTS: The incidence of symptomatic hypocalcemia was significantly lower in group A (P = .02), whereas similarly low levels of calcemia were observed in both groups on POD1 (37% and 30%, respectively; P = not significant) and persisted on POD2 (14% and 6%, respectively; P = not significant). Patients with severe hypocalcemia (<1.90 mmol/L) showed faster recovery in group A compared with group B (6% vs 1%, P = .04). At 5 weeks, calcium and vitamin D levels were similar between the groups. Six months after surgery, 4% (group A) versus 0% (group B) of subjects exhibited permanent hypoparathyroidism (P = .04). CONCLUSIONS: Although the treatment did not correct vitamin D deficiency, perioperative alfacalcidol uptake resulted in decreased transient hypocalcemia and related symptoms in patients undergoing total thyroidectomy.
RCT Entities:
BACKGROUND: The aim of this study was to evaluate the effect of perioperative alfacalcidol on postoperative hypocalcemia after total thyroidectomy. METHODS: A total of 219 patients scheduled for total thyroidectomy were randomized into groups not receiving (group A) or receiving (group B) perioperative alfacalcidol. Postoperative hypocalcemia was compared between groups on postoperative day (POD) 1 and POD2. Patients with hypocalcemia (<2.00 mmol/L) received oral calcium supplementation. Calcium and vitamin D levels were measured at 5-week and 6-month follow-ups. RESULTS: The incidence of symptomatic hypocalcemia was significantly lower in group A (P = .02), whereas similarly low levels of calcemia were observed in both groups on POD1 (37% and 30%, respectively; P = not significant) and persisted on POD2 (14% and 6%, respectively; P = not significant). Patients with severe hypocalcemia (<1.90 mmol/L) showed faster recovery in group A compared with group B (6% vs 1%, P = .04). At 5 weeks, calcium and vitamin D levels were similar between the groups. Six months after surgery, 4% (group A) versus 0% (group B) of subjects exhibited permanent hypoparathyroidism (P = .04). CONCLUSIONS: Although the treatment did not correct vitamin D deficiency, perioperative alfacalcidol uptake resulted in decreased transient hypocalcemia and related symptoms in patients undergoing total thyroidectomy.
Authors: Sumiya Jaan; Ashish Sehgal; Rauf Ahmad Wani; Muneer Ahmad Wani; Khursheed Alam Wani; Bashir Ahmad Laway Journal: Indian J Endocrinol Metab Date: 2017 Jan-Feb
Authors: J Vidal Fortuny; S M Sadowski; V Belfontali; S Guigard; A Poncet; F Ris; W Karenovics; F Triponez Journal: Br J Surg Date: 2018-02-06 Impact factor: 6.939
Authors: G Baud; L Brunaud; J C Lifante; C Tresallet; F Sebag; J P Bizard; M Mathonnet; F Menegaux; R Caiazzo; É Mirallié; F Pattou Journal: J Chir Visc Date: 2020-04-30