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Abstract
The study revealed the importance and the significance of preservation and auto-transplantation of any suspected parathyroid tissues during thyroidectomy and its role in prevention of long term hypocalcaemia and (PHPTH) in thyroid surgery either primary or secondary.
We recommend ligation of distal branches of inferior thyroid artery on thyroid capsule, and avoiding ligation of the main trunk as much as we can to preserve parathyroids blood supply.
Malignancy and hyperthyroidism are major risk factors for hypoparathyroidism; therefore, we recommend subtotal instead of total thyroidectomy in hyperthyroidism and other benign cases (to reduce the complications) and transplantation of parathyroids if possible (at least one) in malignancy.
Routine serum calcium monitoring should be reserved for patients whom have undergone either total or completion thyroidectomy or whom otherwise might be at risk of symptomatic hypocalcaemia, because all patients with hemithyroidectomy did not develop hypocalcaemia or tetany.
Patients with symptoms or signs of hypocalcaemia or a fall in serum calcium below 7.4 mg/dL should be treated by oral calcium. When symptoms of hypocalcaemia persist and the total serum calcium is below 7 mg/dL, intravenous calcium is warranted, early post operatively with repeated monitoring of serum calcium till reaching normal range.