{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T20:15:18Z","timestamp":1775074518292,"version":"3.50.1"},"reference-count":49,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,5,31]],"date-time":"2017-05-31T00:00:00Z","timestamp":1496188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the effect of truncal ligation of the inferior thyroid artery in comparison with ligation of secondary branches as a risk factor for postoperative hypocalcemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>A search was conducted using the Medical Subject Headings and free\u2010text terms \u201cthyroid*\u201d and \u201ctruncal ligation*\u201d in PubMed Central, PubMed, Embase, and Latin American and Caribbean Health Sciences Literature databases for trials published between January 1985 and October 2016. A Google search with the same terms, and a \u201csnowball\u201d approach was designed to retrieve the largest number of articles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>Controlled trials (randomized or not) of adults who underwent total\/bilateral subtotal thyroidectomy were searched, and truncal ligation versus nontruncal ligation of the inferior thyroid artery was compared. Data were acquired following Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses guidelines. Methodological quality of randomized controlled trials was assessed in accordance with Cochrane Collaboration guidelines, and for nonrandomized controlled trials, the Newcastle\u2010Ottawa quality assessment scale for cohort studies was used. Pooled results are presented as risk differences with a random effects model. The main outcome was postoperative temporary and definitive hypocalcemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found 11 nonrandomized controlled trials and nine randomized controlled trials with 1940 patients: 977 patients in the trunk ligation group and 963 patients in the nontruncal ligation group. The risk difference for biochemical hypocalcemia was 6% (95% confidence interval [CI]: 2% to 11%), for symptomatic hypocalcemia 6% (95% CI: 1% to 10%), and definitive hypocalcemia 0% (95% CI: \u22121% to 1%) in the whole group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Truncal ligation of the inferior thyroid artery increases the risk of temporary and symptomatic hypocalcemia but not the risk of definitive hypocalcemia. <jats:italic>Laryngoscope<\/jats:italic>, 128:534\u2013541, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26681","type":"journal-article","created":{"date-parts":[[2017,5,31]],"date-time":"2017-05-31T09:28:48Z","timestamp":1496222928000},"page":"534-541","source":"Crossref","is-referenced-by-count":21,"title":["Inferior thyroid artery ligation increases hypocalcemia after thyroidectomy: A meta\u2010analysis"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5563-8840","authenticated-orcid":false,"given":"Alvaro","family":"Sanabria","sequence":"first","affiliation":[{"name":"Department of Surgery Colombian Foundation for Cancerology\u2013Life Clinic, University of Antioquia Medellin Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz P.","family":"Kowalski","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Service and Otorhinolaryngology Department AC Camargo Cancer Center Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Tartaglia","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences \u201cSapienza\u201d University of Rome Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,5,31]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000129357.58265.3c"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(02)01310-8"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.128.4.389"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-014-2622-z"},{"key":"e_1_2_6_6_1","first-page":"27","article-title":"Is ionized calcium a reliable predictor of hypocalcemia after total thyroidectomy?. 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