الفهرس 
IntroductionOnly 14 pages are availabe for public view
Abstract
Thyroidectomy is one of the most frequently performed operations in the field of general surgery. Total thyroidectomy is the treatment of choice for many thyroid diseases.
Although the incidence of postoperative complications is acceptable, they may be extremely uncomfortable and incapacitating. The most common metabolic complications are disorders of calcium ion concentrations. Postoperative hypocalcemia is a common complication of thyroidectomy. Magnesium is known to modulate serum calcium levels and hypomagnesemia may impede correction of hypocalcemia.
The aim of our study is to determine the prevalence of hypomagnesemia after total thyroidectomy and to evaluate the relationship of hypomagnesemia with transient and permanent hypocalcemia.
This study was a prospective analytical one done between July 2019 and July 2020 including fifty patients (n=50) who underwent total or completion thyroidectomy. Our patients were divided according to adjusted serum calcium levels and clinical manifestations of hypocalcemia into 2 groups, group (A) for normocalcemic patients (clinical and biochemical) and group (B) for hypocalcemic patients (clinical or biochemical). And each group was subdivided into two subgroups according to serum magnesium levels (normomagnesemia and hypomagnesemia). All patients were performed by the same surgical team with standard procedure at endocrine surgery unit, Ain Shams University Hospitals and Al-Agouza police hospital.
The age of our cases ranged from 21 to 74 years, 36 females (72%) and 14 males (28%), duration of surgery ranged from 60 to 130 minutes, blood loss was minimal (less than 100 ml) in most of the patients. As regard to the postoperative diagnosis simple nodular goiter was detected in 37 cases (74%), toxic goiter was positive in 5 cases (10%) while malignant diseases were detected in 8 cases (16%).
In the first day postoperative, biochemical hypocalcemia was detected in 18 cases (36.0%) and hypomagnesemia was detected in 62%, from the hypocalcemic group there were 88.8% with hypomagnesemia while in the normocalcemic group, there were 46.8% with hypomagnesemia.
In the postoperative period 12 patients in this study had manifestations of clinical hypocalcemia (24%); all of these 12 patients (100%) had biochemical hypocalcemia. All of the cases (100%) with symptomatic hypocalcemia had low serum magnesium levels while as for the patients with only biochemical hypocalcemia, 66 % had hypomagnesmia.
Post thyroidectomy hypomagnesemia was found to be a good predictor of postoperative biochemical hypocalcemia and a good predictor and may be the cause of clinical manifestations of hypocalcemia. So, correction of both hypomagnesemia and hypocalcemia is necessary for prompt resolution of symptoms of refractory hypocalcemia after total thyroidectomy.