IMPlementation of a symptom based Algorithm for Calcium management after total Thyroidectomy

Afgerond onderzoek

Hypocalcemia is a common complication after a total thyroidectomy. About 25% of the patients have low calcium levels in the blood serum after surgery. Resection of one or more parathyroid glands, but also ischemia (whether or not temporary) or edema around the operation site could cause postoperative hypocalcemia. Unfortunately, there is no evidence-based guideline for the treatment of this common problem. Treatment is usually based on the serum calcium and sometimes also the parathyroid hormone (PTH). However, recent studies suggest that in many cases this leads to overtreatment and that only treating patients who are symptomatic is more efficient and safe. In response to this finding, a treatment algorithm has been developed for Dutch practice based primarily on symptoms. The algorithm is expected to help optimize diagnostics and possibly prevent unnecessary treatment. This means that the number of blood tests and outpatient visits can be reduced and therefore also the burden on patients. 

The purpose of this study is to investigate the effectiveness and safety of a new treatment algorithm for the treatment of hypocalcemia after a total thyroidectomy. This will be examined in a prospective multicenter trial conducted in ten hospitals in the Rotterdam region.  

Inclusion criteria
1. Elective total or totalization thyroidectomy.
2. Age ≥ 18 years

Exclusion criteria
1. Preoperative abnormal corrected serum calcium (reference values 2.20 - 2.65 mmol/L)
2. Hyperparathyroidism
3. History of epilepsy
4. Pregnant
5. Insufficient command of Dutch
6. Incapable of legal consent

Contact details
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