title: Terminal or truncal ligation of the inferior thyroid artery during thyroidectomy? A prospective randomized trial.
abstract: BACKGROUND
  Thyroidectomy is a common procedure in general and endocrine surgery. The technique of ligation of inferior thyroid artery (ITA) has been invoked as a possible cause of appearance of postoperative hypocalcemia.
  
  
  METHODS
  We performed a prospective randomized study involving 184 patients undergoing total thyroidectomy to evaluate the differences of truncal ligation versus distal ligation of ITA in terms of postoperative hypocalcemia, vocal fold palsy, voice and swallowing impairment. The patients were divided into group A (trunk ligation of ITA) and group B (terminal branches ligation of ITA).
  
  
  RESULTS
  We evaluated postoperative PTH and calcemia (immediate, 6 and 12 months after thyroidectomy), postoperative day of discontinuation of calcium and vitamin D supplementation, voice and swallowing complaints, evaluated by mean of two specific tests available in literature, day of hospital discharge.
  
  
  CONCLUSIONS
  The only significant differences between the two groups were a higher immediate postoperative calcemia and a greater number of patients discharged without calcium and vitamin-D supplementation in the group B. In conclusion, no substantial differences were found between the two groups. The choice depends on the experience of the surgeon.
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127, Palermo, Italy. Electronic address: giorgio.romano@unipa.it.
authors.forename: G
authors.initials: G
authors.lastname: Romano
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127, Palermo, Italy. Electronic address: gregorio.scerrino@tiscali.it.
authors.forename: G
authors.initials: G
authors.lastname: Scerrino
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127, Palermo, Italy. Electronic address: giuseppe.profita@unipa.it.
authors.forename: G
authors.initials: G
authors.lastname: Profita
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127, Palermo, Italy. Electronic address: amatomed@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Amato
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127, Palermo, Italy. Electronic address: giuseppe.salamone@unipa.it.
authors.forename: G
authors.initials: G
authors.lastname: Salamone
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127, Palermo, Italy. Electronic address: g.dibuono@libero.it.
authors.forename: G
authors.initials: G
authors.lastname: Di Buono
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127, Palermo, Italy. Electronic address: clotildelopiccolo@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Lo Piccolo
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127, Palermo, Italy. Electronic address: vincenzosorce@me.com.
authors.forename: V
authors.initials: V
authors.lastname: Sorce
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127, Palermo, Italy. Electronic address: antonino.agrusa@unipa.it.
authors.forename: A
authors.initials: A
authors.lastname: Agrusa
authors.affiliation: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via L. Giuffrè, 5, 90127, Palermo, Italy. Electronic address: gaspare.gulotta@unipa.it.
authors.forename: G
authors.initials: G
authors.lastname: Gulotta
mesh_terms: D000368:Aged; D002118:Calcium / Q000008:administration & dosage; D003680:Deglutition Disorders / Q000209:etiology; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D006996:Hypocalcemia / Q000188:drug therapy / Q000209:etiology; D007037:Hypothyroidism / Q000188:drug therapy / Q000209:etiology; D008026:Ligation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013959:Thyroid Diseases / Q000601:surgery*; D013961:Thyroid Gland / Q000098:blood supply*; D013963:Thyroid Hormones / Q000008:administration & dosage; D016606:Thyroid Nodule / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage; D014826:Vocal Cord Paralysis / Q000209:etiology
chemical_list: D013963:Thyroid Hormones; D014807:Vitamin D; D002118:Calcium
keywords: Inferior thyroid artery; Multinodular goiter; Thyroidectomy