Comparison of frequency of clinical tetany between truncal ligation and peripheral ligation of inferior thyroid arteries in subtotal thyroidectomy

Aim: to compare the frequency of clinical tetany in patients undergoing subtotal thyroidectomy with truncal ligation and peripheral ligation of inferior thyroid arteries. methods: this was a randomized controlled trial study done in department of surgery,mayo hospital,lahore,from 01-01-2011 to 30-06-2011 (six months duration). patients having simple multinodular goiter,colloid multinodular,goiter,toxic controlled multinodular goiter of both gender between 20-60 years of age were included in the study and patients having cancer of thyroid,recurrent goiter,single lobe enlargement,and who did have preoperative laboratory and clinical hypocalcaemia or any skeletal pathology and who had received preoperative and postoperative blood transfusions were excluded from study. one hundred patients fulfilling the inclusion criteria were selected from ward by lottery method and their informed consent was taken. their demographic data was collected. a total of 100 patients were eligible for the study. there was no ethical issue in the procedure as both truncal ligation and peripheral ligation of inferior thyroid arteries are accepted internationally. patients in group a (n=50) underwent ligation of the peripheral branches of the inferior thyroid arteries. in group b (n=50) these arteries were ligated on main trunk. in all patients the operation was performed under gereral anesthesia. patients were prepared for general anesthesia and subtotal thyroidectomy was performed. results: in the comparison of clinical tetany between both groups,only 2 (4%) patients in group a and 14 (28%) patients in group b developed clinical tetany which is statistically significant (p 0.003). conclusion: it 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 a safe and effective technique for subtotal thyroidectomy.