ESPE Abstracts

Background: To evaluate the efficacy of thyroidectomy, it is necessary to know its complications; however, there is a great discrepancy in the literature regarding its incidence. A greater surgical aggressiveness achieves better control of the disease, but may be accompanied by more complications. Hypocalcemia is the most frequent potential complication after thyroidectomy, but its persistence can lead to serious systemic effects. The objective of this study is to evaluate the indications for total thyroidectomy in our center, its treatment, and the incidence of complications in thyroidectomized patients.

Methods: In this cross-sectional study, patients who required total thyroidectomy from 2018 to 2022 were included. In these patients, loading doses of vitamin D were administered on days prior to surgery and preoperative and postoperative serum calcium levels were evaluated at 24, 48 and 72 hours. The indication, complications and treatment were recorded for all patients.

Results: 60% (3/5) of the patients underwent total thyroidectomy due to RET gene mutation, while 40% (2/5) suffered from pathological thyroid nodule (1/2 metastatic papillary carcinoma and 1/2 encapsulated follicular carcinoma). The mean age was 8.8 years (Range 5-13) and 80% (1/5) were male. Although 20% (1/5) had pre-surgical laboratory abnormalities (elevated calcitonin), no patient with RET mutation had a tumor in the surgical specimen. 40% (2/5) of the patients presented hypocalcemia in the first 24 hours after surgery, both men. Age and duration of surgery did not correlate significantly with hypocalcemia, P > 0.05. There were no other complications. Average length of stay was 5 days. 80% (4/5) required lower doses of levothyroxine than the theoretical dose which corresponds to them by age, P<0.05.

Conclusions: In our review, most surgeries were performed prophylactically due to RET mutation. The incidence of hypocalcemia is less than 50% in total thyroidectomy in our center. Our study did not report a significant correlation between hypocalcemia and duration of surgery or patients’ age.