This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Meta‐analysis of routine calcium/vitamin D3 supplementation versus serum calcium level‐based strategy to prevent postoperative hypocalcaemia after thyroidectomy.

Published: 25th June 2019

Authors: A. Sanabria, A. Rojas, J. Arevalo

Background

The aim was to assess the effectiveness of routine administration of calcium +/– vitamin D3 compared with a serum calcium level‐based strategy to prevent symptomatic hypocalcaemia after thyroidectomy.

Method

RCTs comparing routine supplementation of calcium +/– vitamin D3 with treatment based on serum calcium levels measured after total thyroidectomy, published between 1980 and 2017, were identified in MEDLINE, Embase, LILACS and Google Scholar databases. Risk of bias was evaluated using the Cochrane Collaboration tool. Risk differences were calculated by random‐effects meta‐analysis. Meta‐regression and cumulative meta‐analysis were used to explore the best therapeutic approach.

Results

Fifteen studies with 3037 patients were included, and seven treatment comparisons were made. Routine supplementation with calcium + vitamin D3 offered a lower risk of symptomatic (risk difference (RD) –0·25, 95 per cent c.i. –0·32 to –0·18) and biochemical (RD –0·24, –0·31 to –0·17) hypocalcaemia than treatment based on measurement of calcium levels. The number needed to treat was 4 (95 per cent c.i. 3 to 6) for symptomatic hypocalcaemia. No publication bias was found; although heterogeneity was high for some comparisons, sensitivity analysis did not change the main results.

Conclusion

Routine postoperative administration of calcium + vitamin D3 is effective in decreasing the rate of symptomatic and biochemical hypocalcaemia.

Full text

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Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons’ national registry. BJS 2019; 106: 1495-1503.

Authors: N. Patel, R. J. Egan, B. R. Carter, D. M. Scott‐Coombes, M. J. Stechman, A. Afzaal et al.

Meta‐analysis of routine calcium/vitamin D3 supplementation versus serum calcium level‐based strategy to prevent postoperative hypocalcaemia after thyroidectomy.

Background

Method

Results

Conclusion

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