Whic patients with asymptomatic hypocalcemia after total thyroidectomy should be treated?

Introduction Hypocalcaemia is the most frequent early complication after total thyroidectomy. In the asymptomatic forms the need for medical treatment is still discussed The aim of the study was to identify which patients with asymptomatic hypocalcemia after total thyroidectomy will subsequently need therapy. METHODS We performed 195 consecutive TT . We preoperatively monitored :thyroid hormones, calcium, PTH, Vit.D and albuminemia . During the post-operative time, calcemia and PTH values were evaluated both on the first and on the second day after surgery, whereas calcemia alone was again evaluated 5 days and 15 days after surgery. Asymptomatic patients, but with calcemia <8 mg / dl did not receive therapy, while symptomatic patients received calcium and Vit.D. RESULTS We found postoperative hypocalcemia in 62 patients , 39 of which were asymptomatic , while 33 were symptomatic. During the 5-day postoperative check, 8 out of 39 patients became symptomatic, showing decreased calcium values. In the other 31 patients, a normal calcium level was restored. Statistical analyses have shown that upper-limit levels of preoperative calcium for female patients could predict symptoms of hypocalcaemia in patients initially asymptomatic (p <0.05) CONCLUSION Asymptomatic hypocalcemia after total thyroidectomy should not always be treated. Our study has shown that pre-operative values of calcium at the upper limits for female patients should suggest undertaking medical treatment even for patients initially asymptomatic