The ımpact of bilateral ınferior thyroid artery truncal ligation and recurrent laryngeal nerve dissection on early postoperative blood calcium levels after total thyroidectomy.

ABSTRACT: Objective: Early postoperative calcium levels were evaluated following total thyroidectomy with respect to bilateral inferior thyroid artery truncal ligation and reccurent laryngeal nerve dissection. Material and Method: Ninety two patients with multinodular goitre were treated with total thyroidectomy, and randomised according to the study protocol. Bilateral inferior thyroid artery truncal ligation together with dissection of reccurent laryngeal nerve was performed in group-I (no:40). In groups-II patients (n:52), Inferior thyroid artery was ligated at the level of the thyroid gland entrance and dissection of nervus laryngeus inferior was not performed. The calcium levels were obtained 12 hours before and 24.72 hours after the operation. Results: There were no significant differences in age, gender, operating time and hospitalisation time between the two groups . The calcium levels were similar in both groups at preoperative, first postoperative day and third postoperative day (p=0.07; p=0.29; p=0.51, respectively). The calcium level of group-I at postoperative first day (p<0.018) and the calcium level of group-II at postoperative third day (p<0.002) were istatistically lower from levels measured in preoperative period. Postoperative Chvostek and Trousseau signs were positive in 4 patients of group -I (10%) and 5 patients of Groups-II (9.5%) (p=0.71). None of the patients developed aphonia and respiratory distress. Conclusion: Truncal ligation of inferior thyroid artery together with recurran nerve dissection does not cause prominent hypocalcemia, when compared with the ligation of thyroid artery at the level of entering the thyroid gland and nondissected reccurent laryngeal nerve. During the postoperative period, both methods cause similar rates of early hypocalcemia. In fact, these maneuvers did not cause either disphonia/aphonia or respiratory distress after total thyroidectomy.

Yunus Topal, Mehmet Lari Gedik, İbrahim Karagöz, Doğan Gönüllü, Soykan Arıkan, Vahit Tunalı, Ferda Nihat Köksoy

Journal of Academic Research in Medicine (JAREM) ISSN:2146-6505, E-ISSN: 2147-1894. 02/2014;