Background: Since the parathyroid glands are vulnerable to damage from an accidental movement or a transient, uncontrollable force, the surgeon must exercise massive care when handling them throughout the entire surgery.
Aim of the work: The aim of this study is to compare the conventional thyroidectomy versus subcapsular saline injection in the incidence of hypocalcemia due to postoperative hypoparathyroidism.
Patients and Methods: This is a prospective randomized study included 40 patients presented by a varies of thyroid pathology who are indicated for total thyroidectomy at the general surgery outpatient clinic and admitted to the department of general surgery, Al-Azhar university hospitals in Assiut and operated from October 2022 to December 2023. These patients were randomly divided into 2 groups: Group “A" who underwent thyroidectomy with subcapsular saline injection [SCASI]. Group “B" who underwent the conventional thyroidectomy. All patients were diagnosed to have goiter on the basis of clinical symptoms and signs, serum level of thyroid hormones and thyroid stimulating hormones, Antibody detection, neck ultrasound, and FNAC of the thyroid.
Results: We compared between the two groups regarding the total Ca level all over the follow up periods, and we found that no statistically significant difference between the two groups [P > 0.05 at all follow-up periods]. However, the difference between the two groups regarding the ionized Ca was significant at the 1st week, 1st month and 6th month postoperatively [P = 0.002, 0.02, 0.03 respectively].
Conclusion:  The SCASI approach may decrease the occurrence of temporary and permanent hypoparathyroidism by shielding the parathyroid glands from physical and heat damage. This approach is simple, even for inexperienced surgeons.