Impact of Oral Administration of Calcitriol to Prevent Symptomatic Hypocalcemia After Total Thyroidectomy: Systematic Review and Meta-Analysis Publisher Pubmed



Dadkhah PA¹ ; Farshid A² ; Khademi R³ ; Yaghoubi S⁴ ; Asadzadeh A⁵ ; Moharamnejad N² ; Jadidian F⁶ ; Ziaei SA⁷ ; Haghshoar S⁸ ; Salimi O⁹ ; Shafagh SG¹⁰ ; Rabiei N¹¹ ; Shahsavari S¹² ; Shokravi S¹³ Show All Authors Show Affiliations
Source: Scandinavian Journal of Surgery Published:2024

Abstract

Background: One of the most common complications of total thyroidectomy is post-operative transient or persistent hypoparathyroidism that can cause symptomatic hypocalcaemia. To prevent this complication, shorten the period of hospitalization and reduce morbidity, routine supplementation of oral vitamin D and calcium has been suggested. This systematic review and meta-analysis aims to critically assess the association between pre-operative calcitriol supplementation and post-operative hypocalcaemia. Methods: Randomized controlled trial studies were identified by searching PubMed, Scopus, and Google Scholar databases up to 30 March 2023. Screening of titles, abstracts, and full texts of articles were performed, and data were extracted for a meta-analysis. Results: This meta-analysis includes data from nine randomized controlled trials with a total of 1259 patients but with significant heterogeneity. The results demonstrate that calcium levels were higher in patients who had pre-operative calcitriol supplementation, with a weighted mean difference (WMD) 0.18 (95% confidence interval (CI) = 0.00, 0.37). Pre-operative calcitriol supplementation did not lead to significant changes in parathyroid hormone (PTH) levels, with WMD −0.49 (95% CI: −1.91, 0.94). Conclusion: Pre-operative calcitriol supplementation leads to higher calcium levels, but the high heterogeneity of the included studies (79% to 98.7%) could affect the results. © The Finnish Surgical Society 2024.