ABSTRACT
Thyroid cancer is a common head and neck malignant tumor,it has become a malignant tumor of the highest incidence in young women in China.The treatment of thyroid cancer is a surgery-based comprehensive therapy,and the protection of the parathyroid gland during surgery has always been a major problem for clinicians.The methods for protection of parathyroid glands are in situ preservation or immediate parathyroid autotransplantation according to whether or not the blood supply can be maintained.To identify the parathyroid gland is the key issue of the protection during thryoidectomy.This article reviews the recent progress of the identification and protection of parathyroid glands at home and abroad.
ABSTRACT
Objective To investigate the protection of the parathyroid in thyroid cancer operation,reduce the postoperative complications of hypoparathyroidism.Methods Selected 107 cases of thyroid cancer patients from Mar.2013 to Fed.2014 who were underwent thyroid total excision + Ⅵ lymphadenectomy.Identified and preserve in situ of parathyroid according to the typical appearance.Identified the parathyroid on the surface of thyroid and Ⅵ lymph node specimen carefully.Sented a part of the suspected tissue to intraoperative frozen section examination,transplant residual tissue to stemocleidomastoid muscle after confirmed.According to postoperative pathological diagnosis,determined the specimen of thyroid and Ⅵ lymph node with or without removed parathyroid.Monitored serum calcium and symptomatic treatment for 1 to 3 days after operation.Results Error cut rate of parathyroid was 11.4％.In vitro parathyroid autograft rate was 54.4％.Hypocalcemia occurred in 32.7％.Symptomatic hypocalcemia occurred in 16.8％.Permanent hypocalcemia did not happen.Conclusions In thyroid cancer operation,accurate identification of parathyroid is the precondition of preservation in situ and self transplantation,is the effective methods to reduce error removal and decrease postoperative hypocalcemia.