Comparison of Parathyroid Gland Preservation Rates between Open and Endoscopic Total Thyroidectomy for Papillary Thyroid Carcinomas.
10.16956/kjes.2012.12.2.98
- Author:
Jungbin KIM
1
;
Inseok PARK
;
Hyunjin CHO
;
Geumhee GWAK
;
Keunho YANG
;
Byungnoe BAE
;
Kiwhan KIM
;
Sehwan HAN
Author Information
1. Department of Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea. ggh2008@paik.ac.kr
- Publication Type:Original Article
- Keywords:
Endoscopic;
Hypocalcemia;
Hypoparathyroidism;
Parathyroid;
Total thyroidectomy
- MeSH:
Calcium;
Drainage;
Humans;
Hypocalcemia;
Hypoparathyroidism;
Medical Records;
Methods;
Muscle Cramp;
Parathyroid Glands*;
Parathyroidectomy;
Retrospective Studies;
Seizures;
Seroma;
Thyroid Gland*;
Thyroid Neoplasms*;
Thyroidectomy*
- From:Korean Journal of Endocrine Surgery
2012;12(2):98-101
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Incidental parathyroidectomy is the most common and unexpected consequence of a total thyroidectomy. It can cause hypocalcemia symptoms such as muscle cramping and even seizures. We conducted this study to compare several factors including the preservation rate of parathyroid glands during both a bilateral axillo-breast approach endoscopic thyroidectomy (BABA) and a conventional open thyroidectomy (CT) for papillary thyroid carcinomas. METHODS: We retrospectively reviewed the medical records of 299 papillary thyroid cancer patients who had a total thyroidectomy between January 2008 and December 2011. We grouped the patients into two groups: BABA (n=70) and CT (n=229). We analyzed age, tumor size, operation time, the number of preserved and removed parathyroid glands, amount and duration of seroma drainage, pain score, hypocalcemia symptoms, and serum total calcium level in both the BABA and CT groups. RESULTS: We observed a younger age (under 45 years old) (P=0.000), smaller tumor size (P=0.000), longer operation time (P=0.000), larger amount of drainage (P=0.000), longer duration of drainage (P=0.007), and larger pain score (P=0.000) in the BABA group. Of the 70 patients that received an endoscopic thyroidectomy, we preserved all four parathyroid glands in 56 patients (78.6%). Of the 229 patients that received an open thyroidectomy, we preserved all four parathyroid glands in 141 patients (61.6%, P=0.004). CONCLUSION: BABA results in more extensive tissue damage over a longer period of time than CT. However, BABA was an excellent method for preserving parathyroid glands when compared with CT for thyroid carcinoma. Thus, it seems to be feasible performing BABA when it matches the indications.
