PARATHYROID INJURY LEADING TO HYPOCALCAEMIA IN TOTAL VERSUS SUBTOTAL THYROIDECTOMY

Objective: The objective of this study is to relate the occurrence of transient hypocalcaemia in subtotal versus total thyroidectomy due to parathyroid damage.Study Scheme: Pseudo Experimental Study.Place and Time of Study: This study was led in indoor Department of General Surgery Bahawlpur Victoria Hospital from March 2016 to june 2017.Materials and Methods: 60 patients of both the genders and 25-60 year of age admitted for thyroidectomy were included in this study. All patients were distributed into two sets. 30 patients were in total thyroidectomy set and 30 patients were in sub-total thyroidectomy set.Thyroidectomies were accomplished by a regular method of capsular dissection; the total thyroidectomy technique comprised the expulsion of entire gland from one tracheoesophageal section to other. In subtotal thyroidectomy technique, complete lobectomy was accomplished on prevailing part and couple of grams of thyroid tissue was left beside the posterior aspect of contralateral part. Each one of the surgical specimen was subject of histopathological exam with the purpose of evaluating the presence of parathyroid gland in surgical specimen. Parathyroid damage as well as transient hypocalcaemia was evident in both groups.Results: The presence of age in this study was from 25 to 60 years. Women were in majority in both sets. Postoperative parathyroid damage was evident in 36.7% of the total thyroidectomy group as compared to 10% in Sub-total thyroidectomy group (P=0.014). While transient hypocalcaemia was seen in Total thyroidectomy group 23.3 % as compared to 6.7% in sub-total thyroidectomy group (P=0.070). Majority of fleeting hypocalcaemia was realised in patients with postoperative parathyroid injury in both groups.Conclusion: The sub total thyroidectomy has low chance of damage for parathyroid gland and is better option for reducing risk of passing hypocalcaemia