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CLINICAL TRIAL
COMPARATIVE STUDY
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL
Does near total thyroidectomy offer advantage over total thyroidectomy in terms of postoperative hypocalcemia?
International Journal of Surgery 2009 April
Total thyroidectomy (TT) has emerged as a surgical option in the surgical treatment of patients with multinodular goiter. TT carries potential risk to all parathyroid glands and both recurrent laryngeal nerve. The aims of this study are to evaluate the difference between serum calcium levels before and after total and near total thyroidectomy and to compare the rate of postoperative hypocalcemia according to surgical procedures. This prospective study included 143 consecutive patients undergoing surgical therapy for non-toxic multinodular goiter. Patients were randomly assigned to surgical procedures. Patients in group 1 (n=75) performed TT, and patients in group 2 (n=68) performed near total thyroidectomy (NTT). The difference between serum calcium levels and percentage decrease in serum calcium levels before and after thyroidectomy were calculated. TT had a 33-fold (OR: 33.1; 95% CI: 7.5-145.02) increased risk for hypocalcemia. Moreover, TT had a 8-fold (OR: 8.09; 95% CI: 3-21.4) and a 27-fold (OR: 27.9; 95% CI: 3.5-219.6) higher risk than NTT for moderate and severe percentage decreases in serum calcium level, respectively. NTT can offer an advantage over TT in terms of postoperative hypocalcemia in the patients with benign multinodular goiter.
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