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

Area of Science:

• Endocrinology
• Surgical Oncology
• Vascular Surgery

Background:

• Postoperative hypocalcemia is a significant complication following thyroidectomy.
• The ligation technique for the inferior thyroid artery may influence the incidence of hypocalcemia.

Purpose of the Study:

• To compare truncal ligation of the inferior thyroid artery versus ligation of secondary branches.
• To assess the impact of these ligation methods on postoperative hypocalcemia risk.

Main Methods:

• Systematic review and meta-analysis of controlled trials (RCTs and non-RCTs).
• Searched multiple databases (PubMed, Embase, etc.) from 1985 to 2016.
• Assessed methodological quality using Cochrane and Newcastle-Ottawa scales.

Main Results:

• Included 20 trials with 1940 patients (977 truncal ligation, 963 nontruncal ligation).
• Truncal ligation showed a 6% increased risk for biochemical and symptomatic hypocalcemia.
• No significant increase in definitive hypocalcemia risk was observed.

Conclusions:

• Truncal ligation of the inferior thyroid artery is associated with a higher risk of temporary and symptomatic hypocalcemia.
• The risk of definitive hypocalcemia is not significantly affected by truncal ligation.
• Surgical technique for inferior thyroid artery ligation should be carefully considered to mitigate temporary hypocalcemia.