Official publication of Rawalpindi Medical University
Branch Ligation versus Truncal Ligation of Inferior Thyroid Arteries in Total Thyroidectomy: Impact on Transient Hypocalcemia

Keywords

Thyroidectomy
Hypocalcemia,
thyroid diseases
parathyroid hormone
ligation

How to Cite

1.
Aslam S, Chaudhry S, Rehman A, Afzal M, Ahmad MT, Khan MS. Branch Ligation versus Truncal Ligation of Inferior Thyroid Arteries in Total Thyroidectomy: Impact on Transient Hypocalcemia. JRMC [Internet]. 2026 Jun. 30 [cited 2026 Jun. 30];30(2). Available from: https://journalrmc.com/index.php/JRMC/article/view/3000

Abstract

Objective: Following a complete thyroidectomy, transient hypocalcemia is a frequent side effect. The incidence of transitory hypocalcemia following inferior thyroid artery (ITA) branch ligation and truncal ligation was examined in this study. This study compares the two techniques in terms of their effect on calcium levels.

Methods: The ninety-four patients were assigned to truncal ligation and branch ligation groups according to the surgeon's practice. Records were kept of preoperative calcium, intraoperative and postoperative variables, and parathyroid hormone (PTH). Serum calcium and PTH levels were measured one, two, and three months following surgery. The results were evaluated using chi-square, t-, and logistic regression tests.

Results: The truncal ligation group experienced postoperative hypocalcemia considerably more frequently (40.4%) than the branch ligation group (0%; p < 0.001) on postoperative day 1. The truncal ligation group had consistently reduced postoperative calcium and PTH levels at all time points. Truncal ligation was validated as a significant predictor of hypocalcemia by multivariate analysis (OR = 0.007, p = 0.009).

Conclusions: Transient hypocalcemia is considerably less common when the ITAs are branch-ligated following complete thyroidectomy. These findings emphasize the importance of careful vascular preservation for preserving parathyroid function.

Keywords: Thyroidectomy; Hypocalcemia; Thyroid Diseases; Parathyroid Hormone, Hypoparathyroidism: Adverse Effects.

https://doi.org/10.37939/jrmc.v30i2.3000

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Copyright (c) 2026 Salman Aslam, Sadia Chaudhry, Abdur Rehman, Muhammad Afzal, Muhammad Tehseen Ahmad, Muhammad Shuaib Khan