fect of refined anatomy on the protection of parathyroid glands in double thyroid cancer surgery
10.3760/cma.j.issn.1008-6706.2019.09.020
- VernacularTitle: 精细化被膜解剖法用于双侧甲状腺切除术中对甲状旁腺的保护效果观察
- Author:
Hailang CHEN
1
Author Information
1. Department of Oncology, Lanxi People's Hospital, Lanxi, Zhejiang 321100, China
- Publication Type:Journal Article
- Keywords:
Thyroid neoplasms;
Microdissection;
Refined anatomy of the capsule;
Hypothyroidism;
Hypoparathyroidism;
Postoperative hemorrhage
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(9):1106-1109
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the protective effect of refined anatomy on parathyroid glands in double thyroid cancer surgery.
Methods:From January 2012 to December 2017, 31 patients with bilateral thyroid cancer who underwent bilateral total thyroidectomy plus bilateral central lymph node dissection in Lanxi People's Hospital were selected in the study.According to the different admission time, they were divided into 14 cases in the control group (traditional thyroidectomy) and 17 cases in the observation group (fine capsular dissection). The duration of operation, the amount of intraoperative blood loss, the drainage volume at 1 day after surgery, the retention of parathyroid glands, the changes of serum calcium and parathyroid hormone levels, and the decline of thyroid function were compared between the two groups.
Results:The intraoperative blood loss and the 1d drainage volume in the observation group were less than those in the control group [(51.25±23.13)mL vs.(74.62±24.58)mL, (52.71±12.47)mL vs.(63.48±15.69)mL](t=2.722, 2.131, all P<0.05). At 7 days after operation, the parathyroid hormone and serum calcium levels in the observation group were significantly higher than those in the control group[(24.21±10.46)mg/L vs.(16.18±10.57)mg/L, (2.01±0.12)mmol/L vs.(1.89±0.11)mmol/L] (t=2.117, 2.876, all P<0.05). During operation, 31 parathyroid glands were detected in the control group, average (2.6±0.3), 47 parathyroid glands were detected in the observation group, average (3.1±0.4), the difference between the two groups was statistically significant (t=3.863, P<0.05). The transient and permanent parathyroid function decline rates of the control group were 71.4% (10/14) and 7.1% (1/14), which of the observation group were 52.9% (9/17) and 0.0% (0/17).
Conclusion:In bilateral thyroid cancer surgery, the application of refined anatomy can effectively avoid miscuting the parathyroid glands and protect the parathyroid function, which is worthy of clinical promotion.
