Comparison Of Clinical Tetany Between Truncal Ligation And Peripheralligation Of Inferior Thyroid Artery In Subtotal Thyroidectomy

INTRODUCTIONThyroidectomy is one of the most frequently performed operations in the field of general surgery. Thyroid diseases are common worldwide and the surgery of thyroid gland is one of the frequent operations. First recorded thyroidectomy was performed by Albucasis in AD500in Baghdad that was associated with catastrophic haemorrage. Multinodular goiter is one of the commonest thyroid disease encountered in the practice of surgery. The most common surgery being performed for multinodular goiter is subtotal thyroidectomy for the reasons that it is comparatively easier to perform, less time consuming and has a lesser complication rate especially of damage to recurrent laryngeal nerve and parathyroids.Some researches advance that none of the inferior thyroid arteries should be ligated in thyroidectomies or that, if they need to be ligated, that this be performed at the nearest point of entrance to the thyroid gland, in order to protect the parathyroid branch of inferior thyroid arteries. In some studies, it was reported that truncal ligation of inferior thyroid arteries did not lead to damage to parathyroid functions.OBJECTIVEThe objective of study is to compare the frequency of clinical tetany in patients underwent subtotal thyroidectomy with truncal ligation and peripheral ligation of inferior thyroid arteries.STUDY DESIGNRandomized controlled trial study. SETTINGDepartment of General Surgery, Qilu Hospital, Jinan.DURATION OF STUDYOne year from01-01-2011to12-30-2012.SUBJECTS AND METHODOne hundred and forty patients were included in this study. It is divided into two groups70patients in each. Group A=Peripheral ligation of inferior thyroid artery and Group B=Truncal ligation of inferior thyroid artery.RESULTSThe average age was mean±SD42.45±9.53years in group A and41.37±10.42in group B. Twenty one (30%) patients were male in group A and49(70%) patients were female and19(27%) patients were male in group B and51(73%) patients were female with male to female ratio1:2.33in group A and1:2.68in group B.The mean±SD postoperative hospital stay was2.93±1.58in group A and5.04±2.72in group B which is statistically significant (p0.000). The comparison of clinical tetany between both groups, only3(4%) patients in group A and16(23%) in group B which is statistically significant (p0.003).CONCLUSIONIt is concluded that the peripheral ligation of inferior thyroid arteries decreases the chances of postoperative clinical tetany as compared to truncal ligation in subtotal thyroidectomy. Peripheral ligation of inferior thyroid artery is as a safe and effective technique for subtotal thyroidectomy. Peripheral ligation operative technique also reduces the duration of postoperative hospital stay, less risk of postoperative complications in thyroidectomy.