Randomized controlled trial of alfacalcidol supplementation for the reduction of hypocalcemia after total thyroidectomy.

Autor: Genser L; Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France., Trésallet C; Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France., Godiris-Petit G; Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France., Li Sun Fui S; Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France., Salepcioglu H; Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France., Royer C; Department of Anaesthesiology, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, Paris, France., Menegaux F; Department of General, Visceral & Endocrine Surgery, Pitié-Salpêtrière Hospital, Pierre et Marie Curie University (Paris VI), Assistance Publique, Hôpitaux de Paris, 83 Boulevard de l'hôpital, 75013 Paris, Paris 6 University, Paris, France. Electronic address: fabrice.menegaux@psl.aphp.fr.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2014 Jan; Vol. 207 (1), pp. 39-45. Date of Electronic Publication: 2013 Oct 09.
DOI: 10.1016/j.amjsurg.2013.05.007
Abstrakt: Background: The aim of this study was to evaluate the effect of perioperative alfacalcidol on postoperative hypocalcemia after total thyroidectomy.
Methods: A total of 219 patients scheduled for total thyroidectomy were randomized into groups not receiving (group A) or receiving (group B) perioperative alfacalcidol. Postoperative hypocalcemia was compared between groups on postoperative day (POD) 1 and POD2. Patients with hypocalcemia (<2.00 mmol/L) received oral calcium supplementation. Calcium and vitamin D levels were measured at 5-week and 6-month follow-ups.
Results: The incidence of symptomatic hypocalcemia was significantly lower in group A (P = .02), whereas similarly low levels of calcemia were observed in both groups on POD1 (37% and 30%, respectively; P = not significant) and persisted on POD2 (14% and 6%, respectively; P = not significant). Patients with severe hypocalcemia (<1.90 mmol/L) showed faster recovery in group A compared with group B (6% vs 1%, P = .04). At 5 weeks, calcium and vitamin D levels were similar between the groups. Six months after surgery, 4% (group A) versus 0% (group B) of subjects exhibited permanent hypoparathyroidism (P = .04).
Conclusions: Although the treatment did not correct vitamin D deficiency, perioperative alfacalcidol uptake resulted in decreased transient hypocalcemia and related symptoms in patients undergoing total thyroidectomy.
(Copyright © 2014 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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