World Journal of Endocrine Surgery

Register      Login

VOLUME 2 , ISSUE 1 ( January-April, 2010 ) > List of Articles


Hypocalcemia after Thyroidectomy: The Need for Improved Definitions

WU Jessie, Barney Harrison

Citation Information : Jessie W, Harrison B. Hypocalcemia after Thyroidectomy: The Need for Improved Definitions. World J Endoc Surg 2010; 2 (1):17-20.

DOI: 10.5005/jp-journals-10002-1015

Published Online: 01-04-2010

Copyright Statement:  Copyright © 2010; Jaypee Brothers Medical Publishers (P) Ltd.



Hypocalcemia and permanent hypoparathyroidism are important outcome measures after total thyroidectomy. The aim of this article is to identify and highlight the wide variation in the adequacy/definition of these complications as reported in the surgical literature.


Nineteen journal articles (2008) on complications of thyroidectomy and 17 journal articles (2002) on ‘prediction’ of postthyroidectomy hypocalcemia derived from a PubMed search were reviewed.


Only 21% of studies of describing outcome and complications of thyroidectomy defined hypocalcemia, temporary/permanent hypoparathyroidism. 47% of studies on the early prediction of hypocalcemia failed to quote their normal range of serum calcium. When stated, the biochemical definition of hypocalcemia varied from 1.8 to 2.12 mmol/l. There is no consistent definition of post-thyroidectomy hypoparathyroidism.


There is no consensus apparent on literature review as to what constitutes post-thyroidectomy hypocalcemia and hypoparathyroidism. The need to benchmark and define appropriate outcome measures of thyroid surgery demands that this deficit is addressed.

PDF Share
  1. Postoperative hypocalcemia: The difference a definition makes. Head-Neck 2010;32(3):279-83.
  2. Subtotal and near total versus total thyroidectomy for the management of multinodular goiter. World J Surg 2008;32(7):1546-51.
  3. Use of the harmonic scalpel versus conventional haemostatic techniques in patients with Grave disease undergoing total thyroidectomy: A prospective randomised controlled trial. Langenbecks Arch Surg 2008;393(5):675-80.
  4. Total thyroidectomy for the treatment of recurrent graves’ disease with ophthalmopathy. Asian J Surg 2008;31(3):115-18.
  5. The change in surgical practice from subtotal to near-total or total thyroidectomy in the treatment of patients with benign multinodular goiter. World J Surg 2009;33(3):400-05.
  6. Could total thyroidectomy become the standard treatment for Graves’ disease? Surg Today 2010;40(1):22-25.
  7. Bipolar thermofusion vessel sealing system (TVS) versus conventional vessel ligation (CVL) in thyroid surgery: Results of a prospective study. Langenbecks Arch Surg 395(2):115-19.
  8. The efficacy and safety of total thyroidectomy in the management of benign thyroid disease: A review of 932 cases. Can J Surg 2009;52(1):39-44.
  9. Clipless and sutureless endoscopic thyroidectomy using only the harmonic scalpel. Surg Endosc 2009.
  10. Comparison of LigaSure vessel sealing system, harmonic scalpel, and conventional hemostasis in total thyroidectomy. Otolaryngol Head-Neck Surg 2009;141(4):496-501.
  11. The role of rapid PACU parathyroid hormone in reducing post-thyroidectomy hypocalcemia. Otolaryngol Head-Neck Surg 2009;141(6):727-29.
  12. Total Thyroidectomy Is Superior to Subtotal Thyroidectomy for Management of Graves’ Disease in the United States. World J Surg 2009.
  13. An algorithm informed by the parathyroid hormone level reduces hypocalcemic complications of thyroidectomy. World J Surg 2010;34(3):532-37.
  14. The value of various definitions of intrathoracic goiter for predicting intraoperative and postoperative complications. Surgery 2010;147(2):233-38.
  15. Minimally invasive videoassisted total thyroidectomy: An easy to learn technique for skillful surgeons. Head-Neck 2010.
  16. Complications of total thyroidectomy performed by surgical residents versus specialist surgeons. Surg Today 2008;38(10):879-85.
  17. Total thyroidectomy: The procedure of choice for toxic goitre. Asian J Surg 2008;31(2):59-62.
  18. Hypoparathyroidism after total thyroidectomy: A prospective study. Arch Surg 2008;143(2):132-37; discussion 138.
  19. Does autoimmune thyroid disease affect parathyroid autotransplantation and survival? ANZ J Surg 2009;79(5):383-85.
  20. Complications in primary and completed thyroidectomy. Surg Today 2010;40(2):114-18.
  21. Intraoperative parathyroid hormone assay: An accurate predictor of symptomatic hypocalcemia following thyroidectomy. Arch Surg 2003;138(6):632-35; discussion 635-36.
  22. The timing of calcium measurements in helping to predict temporary and permanent hypocalcemia in patients having completion and total thyroidectomies. Ann R Coll Surg Engl 2009;91(2):140-46.
  23. Thyroidectomy and parathyroid hormone: Tracing hypocalcemia- prone patients. Am J Surg 2008;196(2):285-88.
  24. Early postoperative PTH levels as a predictor of hypocalcaemia and facilitating safe early discharge after total thyroidectomy. Asian J Surg 2007;30(3):178-82.
  25. Parathyroid hormone assay predicts hypocalcaemia after total thyroidectomy. ANZ J Surg 2007;77(8):667-70.
  26. Parathyroid hormone levels 4 hours after surgery do not accurately predict post-thyroidectomy hypocalcemia. Surgery 2006;140(6):1016-23; discussion 1023-25.
  27. Hypocalcemia and parathyroid hormone assay following total thyroidectomy: Predicting the future. World J Surg 2006;30(5):825-32.
  28. Predicting calcium status post-thyroidectomy with early calcium levels. Otolaryngol Head-Neck Surg 2002;127(4):289-93.
  29. Intact parathyroid hormone measurement 1 hour after thyroid surgery identifies individuals at high-risk for the development of symptomatic hypocalcemia. Am J Surg 2009;197(5): 5-648; 53
  30. Which criterion of intraoperative iPTH assay is the most accurate in prediction of true serum calcium levels after thyroid surgery? Langenbecks Arch Surg 2007;392(6):693-98.
  31. Intraoperative parathormone measurement from the internal jugular vein predicts post-thyroidectomy hypocalcemia. Langenbecks Arch Surg 2007;392(6):699-702.
  32. A safe and cost-effective short hospital stay protocol to identify patients at low risk for the development of significant hypocalcemia after total thyroidectomy. Laryngoscope 2006;116(6):906-10.
  33. Intraoperative parathyroid hormone assay for management of patients undergoing total thyroidectomy. Head Neck 2006;28(11):990-97.
  34. Serum intact parathyroid hormone as a predictor of hypocalcaemia after total thyroidectomy. ANZ J Surg 2005;75(11):977-80.
  35. Parathyroid hormone as a predictor of hypocalcemia after thyroidectomy. Laryngoscope 2005;115(12):2105-08.
  36. Perioperative parathyroid hormone levels in thyroid surgery: Preliminary report. Laryngoscope 2004;114(4):689-93.
  37. Complications to thyroid surgery: Results as reported in a database from a multicenter audit comprising 3,660 patients. Langenbecks Arch Surg 2008;393(5):667-73.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.