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Role of Preoperative Calcium and Vitamin D Supplementation in Preventing Post-total Thyroidectomy Hypocalcemia: a Systematic Review and Meta-analysis

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Abstract

Thyroidectomy is a frequent surgical procedure to treat both malignant and some benign forms of thyroid disease. Hypocalcemia is a prevalent complication in individuals who underwent thyroidectomy, which is typically treated with intravenous or oral calcium treatment. The purpose of this meta-analysis was to investigate the efficacy of preoperative vitamin D (VD) or calcium supplementation in preventing hypocalcemia after thyroidectomy. Relevant studies were identified through a systematic search of PubMed, Web of Science, EMBASE, and the Cochrane Library databases. The Cochrane risk of bias tool was used to evaluate study quality. The pooled data from relevant studies were analyzed using Review Manager 4.1 and Stata 14.0. All dichotomous variables were subjected to the calculation of 95% confidence intervals (CIs) and odds ratios (ORs). In total, this meta-analysis included 8 randomized controlled trials (RCTs) encompassing 930 patients (740 women, 190 men) who had thyroidectomy alone or in conjunction with additional neck surgery procedures. Significant decreases in hypocalcemia incidence were observed when patients underwent preoperative calcium or vitamin D supplementation (OR 0.59 (95% CI, 0.44–0.81); P = 0.0009), although such preoperative supplementation had no impact on the length of hospitalization due to hypocalcemia as compared to the absence of any prophylactic treatment (OR −0.02 (95% CI, −0.32–0.29); P = 0.91). Preoperative calcium or vitamin D supplementation decreased overall hypocalcemia rates in patients who underwent thyroidectomy. The combination of vitamin D and calcium intake was superior to vitamin D alone in preventing postoperative hypocalcemia. However, these results require additional validation through the completion of well-designed large-scale RCTs.

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Abbreviations

CI:

Confidence interval

PTC:

Papillary thyroid cancer

OR:

Odds ratio

RCT:

Randomized controlled trial

PTH:

Parathyroid hormone

VD:

Vitamin D

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Authors and Affiliations

  1. Breast and thyroid surgery, **hua Maternity and Child Health Care Hospital, Back Hill Road, 266, **hua, ZheJiang Province, 321000, China

    **ao Gang Zheng

  2. Breast and thyroid surgery, **hua Municipal Central Hospital, Renmin East Road, 365, **hua, ZheJiang Province, 321000, China

    Chao Yang Xu

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  1. **ao Gang Zheng
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Correspondence to Chao Yang Xu.

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Zheng, X.G., Xu, C.Y. Role of Preoperative Calcium and Vitamin D Supplementation in Preventing Post-total Thyroidectomy Hypocalcemia: a Systematic Review and Meta-analysis. Indian J Surg (2023). https://doi.org/10.1007/s12262-023-03896-9

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