Inferior thyroid artery ligation increases hypocalcemia after thyroidectomy: A meta‐analysis

Abstract

Truncal ligation of the inferior thyroid artery increases the risk of temporary and symptomatic hypocalcemia but not the risk of definitive hypocalcemia. Laryngoscope, 128:534-541, 2018.

Minimally invasive video-assisted thyroidectomy and transoral video-assisted thyroidectomy: A comparison of two systematic reviews

“…Like 'operative time', this variable affects the overall costs of the procedure, although this is due not so much to the method used as to the possible onset of postoperative hypocalcaemia, which can arise even as long as 48–72 h after the surgery, especially in hyperfunctioning goitres. In addition, the length of hospital stay varies according to local practices: the US authors, generally accustomed to short stays, habitually discharged their patients 24 h after TOETVA or MIVAT, whereas in the Asian and European studies hospital stays were prolonged beyond the 2 nd day, probably to monitor the levels of post-operative calcaemia;[ 40 41 42 43 44 45 46 47 48 49 50 51 52 ] this is indeed in line with our practice.…”

Incidental thyroid carcinomas. A retrospective study

“…Supporters of partial thyroidectomy for incidental carcinoma claim that the motivation of their surgical choice, is a possible definitive postoperative hypoparathyroidism or the possibility of surgical lesions of the inferior laryngeal nerve. These risks, which are always present in thyroid surgery, as demonstrated by our experience (105,106,107), are exceeded by a regulated surgical technique that involves the preparation of the inferior laryngeal nerves along the entire cervical tract and the ligation of the inferior thyroid artery on its branches, near the thyroid capsule. In addition, with regard to the complications of total thyroidectomy, it should be considered that it is certainly more risky a redo surgery on a minimal glandular stump, in a scar tissue residual at first intervention, rather than total ablation.…”

Post-thyroidectomy Hypocalcemia - Risk Factors and Management

“…Moreover, a combination of PTH and calcium assay might be more accurate to indicate the need for calcium replacement, for instance a value of intact PTH one hour postoperatory of higher than 10 pg/mL and a total calcium level higher than 8.5 mg/dL makes calcium supplementation unnecessary (28). Alternatively, a combination of PTH 6 hours after thyroidecomy of less than 12.1 pg/mL and serum total calcium during the first postoperatory day of less than 7.97 mg/dL (a sensitivity of 93.9% and a specificity of 100%) offers a total sensitivity and a specificity of 100% to predict hypocalcemia thus indicating the need of oral intervention as preventive replacement (29).…”