Preservation of parathyroid glands and their functions during reoperation of thyroid carcinoma / 中华内分泌外科杂志

ABSTRACT

Objective To investigate the protection of parathyroid glands and their functions during reoperation of thyroid carcinoma.Methods The clinical data of 39 patients who underwent reoperation of thyroid carcinoma from Jan.2012 to Mar.2017 in our hospital were studied retrospectively.They were divided into two groups (group A17 patients who underwent reoperation within 3 months from initial operation;group B22 patients who underwent reoperation 3 months or longer since the first operation).The numbers of parathyroid including inadvertent parathyroidectomy (IPE) and ischemic parathyroid,and the dyeing conditions in the two groups were observed and recorded respectively.Serum calcium and parathyroid hormone (PTH) levels were determined after operation.Results In group A,10 cases with IPE(7 parathyroid glands were found intraoperative dissection specimens,3 parathyroid glands postoperatieve pathology confirmed),4 parathyroid glands in situ were found ischemia;In group B,4 cases with IPE (4 parathyroid glands were found intraoperative dissection specimens),3 parathyroid glands in situ were found ischemia.All of IPE found through intraoperative dissection and ischemic parathyroid glands were transplanted.A total of 11 parathyroid glands were transplanted in group A(7 cases with 1 parathyroid transplantation and 2 cases with 2 parathyroid transplantation).The number of parathyroid gland transplants in group B was 7 (5 cases with 1 parathyroid transplantation and 1 case with 2 parathyroid transplantation).The rate of IPE in the group A was 58.8％(10/17),significantly higher than 18.2％(4/22) in the group B (P＜0.05);The rate of temporary hypoparathyroidism in the group A was 52.9％ (9/17),significantly higher than in the group B 18.2％(4/22) (P＜0.05);With the follow-up of 3～6 months after surgery,no case with permanent hypoparathyroidism.Conclusion Select the appropriate reoperation time combined the nano-carbon negative development during the reoperation of thyroid carcinoma,can reduce IPE;necessary parathyroid transplantations are effective measures to avoid the postoperative permanent hypoparathyroidism.