Role of pre-operative vitamin D supplementation to reduce post-thyroidectomy hypocalcemia; Cohort study

Use of pre-operative calcium and vitamin D supplementation to prevent post-operative hypocalcaemia in patients undergoing thyroidectomy: a systematic review

“…Nine trials met the inclusion criteria (Figure 1 and Table 1). [16][17][18][19][20][21][22][23][24] They included a total of 912 patients. The trials were published between 2006 and 2019, spanning 14 years.…”

“…All nine trials studied adult populations in surgical in-patient departments, with follow up in out-patient clinics. Two trials were based in Italy, 18,24 two were in Pakistan 17,22 and the others were in India, 20 the USA, 21 Malaysia, 23 Australia 16 and France. 19 Six trials studied patients undergoing total thyroidectomy only: one included patients who had near total thyroidectomy, 20 where less than 1 ml of the thyroid gland is spared excision; one included patients who had completion thyroidectomy (removal of remnant thyroid tissue following less than total thyroidectomy); 16 and one included patients undergoing near total and subtotal thyroidectomy (sparing 3-5 g of thyroid tissue).…”

“…19 Six trials studied patients undergoing total thyroidectomy only: one included patients who had near total thyroidectomy, 20 where less than 1 ml of the thyroid gland is spared excision; one included patients who had completion thyroidectomy (removal of remnant thyroid tissue following less than total thyroidectomy); 16 and one included patients undergoing near total and subtotal thyroidectomy (sparing 3-5 g of thyroid tissue). 17 Indications for surgery included both malignant and benign thyroid disease in eight trials, [16][17][18][19][20][22][23][24] whereas one trial exclusively studied patients with Graves' disease. 21 Follow up ranged between 1 week to 6 months.…”

“…Bhettani et al studied 102 patients, 51 of whom were pretreated with 200 000 IU of vitamin D one day before surgery. 17 Both treatment and control groups were given 700 mg/day of calcium carbonate for 2 days pre-operatively. Post-operatively, both groups received vitamin D and calcium for a month.…”

“…Using Cochrane's risk of bias tool (version 2), one trial had low risk, 16 four were of some concern [17][18][19][20] and four had a high risk of bias. [21][22][23][24] Risk of bias was because of methodological issues around randomisation, concealment, blinding, analysis and reporting.…”