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Endocrine Surgery

(402) Pre-Thyroidectomy Vitamin D&Calcium Administration to Prevent Hypocalcemia: A Systematic Review

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • SA

    Sarah Alayoubi, MBBS

    Resident, PGY-2
    Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
    Jeddah, Makkah, Saudi Arabia

    • Co-Author(s)

  • Jabir Alharbi, MBBS

    Consultant Head & Neck Surgical Oncology
    King Abdullah Medical City
    Jeddah, Makkah, Saudi Arabia

  • Mohammed A. Alshareef, MBBS

    Consultant Otorhinolaryngology- Head & Neck Surgery
    King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah
    Makkah, Makkah, Saudi Arabia

  • MA

    Mohammed Fawzan Alhakami, MBBS

    Medical intern
    King Saud bin Abdulaziz University for Health Sciences
    Makkah, Makkah, Saudi Arabia

  • SA

    Shaden Nabil Alhelali, MBBS

    Doctor
    Ibn Sina National collage for medical studies
    Jeddah , Saudi Arabia

  • GB

    Ghassan Bin Lajdam, MBBS

    Medical intern
    King Saud bin Abdulaziz University for Health Sciences
    Jeddah, Makkah, Saudi Arabia

Disclosure(s):
Sarah Alayoubi, MBBS: No relevant relationships to disclose.
Jabir Alharbi, MBBS: No relevant relationships to disclose.
Mohammed A. Alshareef, MBBS: No relevant relationships to disclose.
Mohammed Fawzan Alhakami, MBBS: No relevant relationships to disclose.
Shaden Nabil Alhelali, MBBS: No relevant relationships to disclose.
Ghassan Bin Lajdam, MBBS: No relevant relationships to disclose.


Introduction: Post-thyroidectomy hypocalcemia is a common complication that results in adverse neurological and cardiac symptoms. The use of calcium and vitamin D has been proposed as a preoperative preventative strategy for this condition. This systematic review and meta-analysis aimed to assess whether preoperative administration of calcium and vitamin D prevents postoperative hypocalcemia.

Methods: Computerized search in Medline, Embase, and CENTRAL databases was performed. Randomized controlled trials (RCTs) comparing preoperative calcium and Vitamin D administration with either placebo or standard therapy were eligible for inclusion. The primary outcomes were the occurrence of hypocalcemia, mean postoperative calcium level, and symptomatic hypocalcemia. The secondary outcomes were the development of permanent hypoparathyroidism and length of hospital stay. Continuous outcomes were represented as mean difference (MD), and dichotomous outcomes were represented as risk ratio (RR).

Results: Total of 9 RCTs that enrolled 1079 patients were found eligible. Postoperative hypocalcemia occurred significantly less in patients who received preoperative calcium and vitamin D (RR = 0.77, 95% CI: 0.60 to 1.00; P = 0.05). Mean postoperative calcium level was significantly higher in the intervention group (MD = 0.10, 95% CI: 0.07 to 0.12; P < 0.00001). The number of patients with symptomatic hypocalcemia was significantly lower in the intervention group (RR = 0.54, 95% CI: 0.38 to 0.76). There was no significant difference between the two groups in cases of permanent hypoparathyroidism and length of hospital stay.

Conclusions: Administration of calcium and vitamin D preoperatively achieves lower rates of post-thyroidectomy hypocalcemia in comparison with placebo and standard therapy.