To assess the application of meticulous capsular dissection technique in total thyroidectomy.

The retrospective analysis of clinical data of 118 patients who received meticulous capsular dissection in Sichuan Cancer Hospital from Jan. 2012 to Dec. 2012 was carried out.

All patients were kept at least one parathyroid gland during operation successfully. One hundred and ninty-seven upper parathyroid glands were found. Among them, the blood supply of 42 upper parathyroid glands came from superior thyroid artery. The other 131 upper parathyroid glands were supplied by inferior thyroid artery. In addition, the lower parathyroid glands were not found in 16 patients. But the other 163 lower parathyroid glands were found during meticulous capsular dissection, 136 of which were supplied by inferior thyroid artery. After this operation, the PTH value was significantly decreased in 62 patients (52.5%). Fifty-six cases recovered the PTH value to normal levels seven days after operation; the other six patients recovered two to four weeks after operation. 23 patients had hypocalcemia after the operation. However, all of them recovered the normal blood calcium four days to 1 month after operation. In this group, all patients received the bilateral dissection of recurrent laryngeal nerve. No patients had permanent recurrent laryngeal nerve damage except the patients who suffered from nerve invasion or damage before operation.

Total thyroidectomy through application of meticulous capsular dissection technique can keep the parathyroid glands and its blood supply well, avoid the damage of recurrent laryngeal nerve and decrease the risk of complication after total thyroidectomy.