Abstract
Hypocalcemia following thyroidectomy is often associated with iatrogenic injury to the blood supply of or inadvertent removal of parathyroid glands. Blood supply of all parathyroids mainly comes from inferior thyroid artery (ITA). Truncal ligation of ITA may cause an ischemic injury to the parathyroid glands theoretically. The aim of this study is to investigate the effect of truncal/terminal ligation of ITA on postoperative hypocalcemia. A total of 139 patients who underwent total thyroidectomy were included in the study. The patients were classified as terminal ligation of ITA (group 1) and truncal ligation of ITA (group 2). The development of hypocalcemia was compared between the two groups. Seventy-one (45.7%) patients were in group 1, while 68 (48.9%) patients were in group 2. The two groups were similar in terms of age, gender, preoperative calcium and vitamin D levels, and final histopathology (p > 0.05). Both biochemical (p = 0.017) and symptomatic (p = 0.028) hypocalcemia were found less in group 1 than in group 2. Terminal ligation of ITA is associated with higher postoperative parathormon and calcium levels. Ligation of ITA close to the thyroid capsule seems to be important to reduce the chance of postoperative hypocalcemia.
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