Hypocalcaemia after subtotal thyroidectomy for thyrotoxicosis.

Area of Science:

• Endocrinology and Thyroid Surgery
• Surgical Outcomes and Complications

Background:

• Thyrotoxicosis management often involves subtotal thyroidectomy.
• Surgical techniques aim to minimize complications such as hypocalcaemia and recurrent laryngeal nerve palsy.

Purpose of the Study:

• To evaluate the incidence of symptomatic and prolonged hypocalcaemia after subtotal thyroidectomy.
• To assess the rate of recurrent laryngeal nerve palsy following the procedure.
• To analyze the efficacy of lateral ligation of inferior thyroid arteries in preventing nerve injury.

Main Methods:

• Retrospective analysis of 81 patients undergoing subtotal thyroidectomy for thyrotoxicosis.
• Monitoring of symptomatic hypocalcaemia (corrected calcium < 2.0 mmol/l) and prolonged hypocalcaemia.
• Assessment for transient recurrent laryngeal nerve palsy.

Main Results:

• A 10% incidence of symptomatic hypocalcaemia was observed.
• Only 1.2% of patients experienced prolonged hypocalcaemia.
• A single case (1.2%) of transient right-sided recurrent laryngeal nerve palsy occurred.

Conclusions:

• Lateral ligation of inferior thyroid arteries is effective in protecting the recurrent laryngeal nerve during subtotal thyroidectomy.
• The study supports continuing this technique, refuting claims that it compromises parathyroid function.
• Careful handling of parathyroid tissue remains paramount to prevent injury, devascularization, or removal.