RESUMO
OBJECTIVE: Thyroidectomy is the most common cause of hypocalcemia. Preservation of parathyroid glands in situ is essential in preventing this complication. The aims of our study were to review patients who underwent parathyroid gland autotransplantation during thyroidectomy, and to compare hypocalcemia rates in patients with and without autotransplantation. MATERIAL AND METHODS: Parathyroid gland autotransplantation was performed in 43 (7.9%) of 543 patients who underwent thyroidectomy between 2008 and 2012. RESULTS: Forty-four parathyroid glands were autotransplanted in 43 patients, including 36 women and 7 men. The median age was 55 (range: 30 to 68). The most common cause of autotransplantation was vascular comprise of the parathyroid gland. Early postoperative hypocalcemia developed in 37% of patients with autotransplantation, and none developed permanent hypocalcemia. Transient and permanent hypocalcemia rates were 9.6% and 0.4% in patients without autotransplantation, respectively. The risk of transient hypocalcemia was significantly high in patients with parathyroid autotransplantation (p<0.001). There was no difference between the two groups in terms of permanent hypocalcemia (p=0.156). CONCLUSION: Despite meticulous dissection, parathyroid glands can be devascularized or removed inadvertently during thyroidectomy. Parathyroid autotransplantation is the best method to maintain parathyroid gland function. Although the risk of transient hypocalcemia is increased following parathyroid autotransplantation, long-term results are satisfactory.
RESUMO
BACKGROUND: Adhesion formation after peritoneal surgery is the main cause of postoperative bowel obstruction, infertility, and chronic pelvic pain. In this study, we evaluated the effect of oral ellagic acid on intra-abdominal adhesions caused by gallstones in rats. MATERIALS AND METHODS: Forty-one Wistar-albino rats were used. Gallstones were dropped to the right lower quadrant of the abdomen to create adhesions. They were divided into 4 groups; sham-operated, intraperitoneal gallstone, oral ellagic acid (control), and intraperitoneal gallstone+oral ellagic acid. On the postoperative 10th day, relaparotomy was performed, adhesions were evaluated according to four different macroscopic adhesion score systems and adhesion-bearing tissues were examined histopathologically. Samples were graded for inflammation, vascularization, and fibrosis. RESULTS: We found that oral administration of ellagic acid lowered all macroscopic adhesion scores. There were significant differences between groups of sham and gallstone; control and gallstone; control and gallstone+oral ellagic acid (P<0.05). CONCLUSION: The ellagic acid administered orally at a dose of 100 mg/kg/d significantly inhibited intra-abdominal adhesion formation and no adverse effects were seen between treatments.