THE EFFECT OF PLASMA CALCIUM AND PHOSPHORUS LEVELS ON THE LIGATION OF INFERIOR THYROID ARTERY
OSMAN DOĞRU, NURİ AYDIN KAMA, ÖMER ŞAKRAK, KAMİL BAKIR
Ankara Numune Hastanesi, 4.Cerrahi Kliniği/ANKARA
One of the major problems after thyroid surgery is hypocalcemia. Because permanent hypocalcemia occurs more frequently after total thyroidectomy, it is likely that direct injury to parathyroid glands results parathyroid insufficiency. But the mechanism of transient hypocalcemia that also occurs after minor surgical procedures, in which parathyroid glands are not in danger, is not clear. A number of theories have been advanced. In this prospective study we looked for the effect of ligation of the inferior thyroid artery proximally upon plasma calcium and phosphorus levels.
Pre and postoperative plasma calcium and phosphorus levels were determined in 306 patients. Hypocalcemia occurred in 41 (13, 4%) patients. The hypocalcemia was asymptomatic in 33(10.7%) and symptomatic in 8(2.5%) patients. in symptomatic group hypocalcemia was permanent in only 1(%03) patient. In the group whose both ATI was ligated, asymptomatic hypocalcemia occurred in 20(%10), symptomatic transient hypocalcemia occurred in 5(%2.5) and permanent hypocalcemia occurred in 1(%0.5) patient. These patient numbers and rates were 10(%12.9), 1(%1.2), 0(%0) in the group in which only one ATI was ligated and 3(%10.3), 1(%3.4), 0(%0) in the group in which none of the ATI was ligated, respectively. The difference between 3 groups was not statistically significant (p > 0.05).
Keywords: HYPOCALCEMIA, THYROIDECTOMY, INFERIOR THYROID ARTERY, COMPLICATIONS