Citation: Abouelnagah G, Ali RF, Ahmed SF and Fouad SM. Routine Calcium and Vitamin D Supplement Post Total Thyroidectomy Patients, Does It Worth? Prospective Randomized Study. Austin J Surg. 2019; 6(22): 1222. Austin J Surg - Volume 6 Issue 22 - 2019 ISSN : 2381-9030 | www.austinpublishinggroup.com Ali et al. © All rights are reserved Austin Journal of Surgery Open Access Abstract Background: Thyroidectomy is the most common surgical procedure performed in the neck by surgeons. Hypocalcemia is the most frequent complication after total thyroidectomy, and it is the main cause of prolonged hospital stay. The value of routine postoperative oral calcium and vitamin D supplementation in preventing symptomatic hypocalcemia after total thyroidectomy is still controversy. Material & Methods: Two hundred and seventy patients who underwent total thyroidectomy for goiters were randomly assigned to routinely receive or not receive oral calcium (3 g/d) and vitamin D (1 μg/d) for 4 weeks post-operatively. Hypocalcemic symptoms, signs, total serum calcium and parathormone levels were monitored and compared between two groups. Results: The incidence of symptomatic and laboratory hypocalcemia was lower in the group receiving the supplement than in the group not receiving it: 9 of 135 patients (6.7%) versus 45 of 135 (33.3%). The hypocalcemic symptoms were minimal in the group receiving the supplement but more severe in the group not receiving it. Serum calcium levels decreased in both groups after surgery but were lower in the supplemented group. Conclusion: Routine administration of oral calcium and vitamin D supplementation is effective in reducing the incidence and severity of hypocalcemia after total thyroidectomy. Keywords: Calcium supplementation; Vitamin D; Hypocalcemia; Thyroidectomy Research Article Routine Calcium and Vitamin D Supplement Post Total Thyroidectomy Patients, Does It Worth? Prospective Randomized Study Abouelnagah G 1 , Ali RF 2 *, Ahmed SF 1 and Fouad SM 1 1 Department of General Surgery, Faculty of Medicine, Alexandria University, Egypt 2 Department of General Surgery, Faculty of Medicine, Kafrelsheikh University, Egypt *Corresponding author: Reda Fawzy Ali, Kafr El Sheik Faculty of Medicine, 202 Gamal Abdel Naser st, Sidi Bishr, Alexandria, Egypt Received: September 05, 2019; Accepted: October 23, 2019; Published: October 30, 2019 Introduction Tyroidectomy is the most common surgical procedure performed in the neck by surgeons. Teodore Kocher recognized recurrent laryngeal nerve injury, myxedema, and tetany as the three main postoperative complications of thyroidectomy as early as 1883. Tetany was attributed to the defciency of thyroid gland until Moussu (1898) could relieve it with an aqueous extract of parathyroid glands. Fourman and colleagues (1963) suggested persistent parathyroid insufciency following transient hypocalcemia [1]. Tey observed persistent parathyroid insufciency in 24% of patients afer thyroidectomy based on depression of serum ionized calcium level by the ethylene diaminetetraacetic acid (EDTA) infusion test [2]. Te immediate manifestations of hypocalcemia are mostly neuro- muscular symptoms and occasionally psychotic states. Ectodermal changes leading on to alopecia, eczema, and cataract may occur as early as 6 months afer the operation. Persistent hypocalcemia may cause intracranial lesions and cardiac arrhythmias. Permanent hypocalcemia causes a substantial impact on the health of patient along with the considerable fnancial loss. Te prevention of signifcant symptomatic hypocalcemia will allow early discharge of post-thyroidectomy patients from the hospital [3]. A combined measurement of iPTH “intact parathyroid hormone” and serum calcium levels is recommended to identify patients at risk for developing hypocalcemia. Severe, progressive hypocalcemia is unlikely with a normal iPTH level, and thus iPTH can be used cautiously to facilitate early discharge for many patients [4]. Routine oral calcium and vitamin D supplements have been proposed to prevent the development of symptomatic hypocalcemia and to increase the likelihood of early hospital discharge afer bilateral surgical treatment of the thyroid gland or exploration of the parathyroid glands [5,6]. Materials and Methods Tis study included 270 (two hundred and seventy) patients sufering from thyroid enlargement who were admitted to the Department of Surgery at Alexandria and Kafrelsheik University hospitals, during a period from January 2016 to December 2017 excluding those patients sufering from chronic renal failure and parathyroid gland diseases. All patients included in this study were subjected to complete history taking, full clinical examination, serum T3, T4, TSH, Ultrasound neck. Blood samples were taken from every patient