Effect of protecting parathyroid in situ in the operation of total thyroidectomy
10.3760/cma.j.issn.1673-0860.2010.02.008
- VernacularTitle:甲状旁腺原位保护技术在甲状腺全切除术中的应用
- Author:
Gao-Song WU
1
;
Xiao-Peng MA
;
Fie LIU
;
Yan-Yan LIU
;
Jie WANG
;
Li-Li HUANG
;
Yu-Ping YIN
;
Ji-Lin YI
;
Sheng-Quan ZOU
Author Information
1. 华中科技大学同济医学院附属同济医院
- Keywords:
Thyroidectomy;
Parathyroid glands;
Hypocalcemia;
Postoperative complications
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2010;45(2):120-123
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of protecting parathyroid glands in situ in the operation of total thyroidectomy by detecting parathyroid hormone after the operation.Methods In the surgical team, 1019 consecutive patients with thyroid diseases were treated with total thyroidectomy.During the operation, parathyroid glands were protected in situ with correctly identifying the parathyroid glands, precisely dissecting its envelope and protecting its blood supply.Serum calcium level and parathyroid hormone were measured before and 24 hours after operation. The patients who had symptomatic hypocalcemia or hypoparathyroidism were given supportive treatment and followed-up. Results At least one of the parathyroid glands was preserved and remained in situ in all cases.Eighty-nine cases (8.7%) had decreased parathyroid hormone levels and 42 cases (4.1%) had complicated symptomatic hypocalcemia.The symptoms of hypocalcemia in all these cases could be controlled by supportive treatment, and serum calcium level and parathyroid hormone had all recovered 1 - 6 months later.If 3 and 4 parathyroid were conserved in situ, the postoperative complication rate was significantly lower than those with 1 and 2 parathyroid conserved(decreased PTH 69/999 vs 20/20, symptoms of hypocalcemia 25/999 vs 17/20, all P <0.01).Conclusion The techniques to protect parathyroid glands in situ are effective measure to prevent the postoperative hypoparathyroidism in total thyroidectomy.
