|Table of Contents|

Clinical effect of parathyroid gland preservation in situ combined with half volume autologous transplantation during thyroidectomy

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 06
Page:
1038-1043
Research Field:
Publishing date:

Info

Title:
Clinical effect of parathyroid gland preservation in situ combined with half volume autologous transplantation during thyroidectomy
Author(s):
WU Erbin; DUAN Honggang; LI Binbin; CHEN Pengjie
The First People's Hospital of Pingdingshan City，the First Affiliated Hospital of Pingdingshan University，Henan Pingdingshan 467000，China.
Keywords:
total thyroidectomy; parathyroid gland; autologous transplantation
PACS:
R736.1
DOI:
10.3969/j.issn.1672-4992.2024.06.009
Abstract:
Objective:To investigate the clinical efficacy of parathyroid preservation in situ combined with half volume transplantation during total thyroidectomy and central area dissection.Methods:A retrospective analysis was conducted on 128 patients with papillary thyroid cancer who underwent total thyroidectomy and central area dissection in our hospital from September 2017 to January 2023.They were divided into three groups according to different parathyroid gland management methods:In situ preservation group (n=58 cases).In situ preservation combined with half volume transplantation group (n=27 cases),and total transplantation group (n=43 cases).Clinical and follow-up data of the three groups were compared and statistically analyzed.Results:The proportion of postoperative PTH reduction in the combined group and total transplantation group was significantly lower than that in the in-situ preservation group (P＜0.05).On the 7th day after surgery,the proportion of PTH reduction in the combined group (7.4%) was lower than that in the total transplant group (27.9%)（χ2=4.356,P=0.037).The proportion of patients with permanent hypoparathyroidism in the combined group (0%) and the total transplantation group (2.3%),which was significantly lower than that in the in situ preservation group (12.1%)（χ2=6.282,P=0.043).At 30 days after surgery,the incidence of low calcium was significantly lower in the combination group (3.7%) and the total transplantation group (7%) compared to the in situ preservation group (27.6%)（χ2=12.310,P=0.002).Conclusion:For parathyroid glands preserved in situ,the combination of parathyroid gland preservation in situ and half volume transplantation has significant advantages as a dual insurance plan when it is difficult to determine blood supply during surgery or when there is a suspected blood supply disorder.The postoperative recovery rate of parathyroid hormone levels is fast,and the proportion of permanent hypothyroidism is low.

References:

［1］ MA TT,CAI F.Clinical analysis of the factors influencing hypoparathyroidism after papillary thyroid carcinomasurgery［J］.Modern Drug Applications in China,2023,17(1):31-34.
［2］ JEONG JY,SONG CM,JI YB,et al.Incidence and risk factors of hypoparathyroidism and hypocalcemia after hemithyroidectomy［J］.Langenbeck's Archives of Surgery,2023,408(1):298.
［3］ 朱精强，赵婉君，苏安平.甲状腺术后并发症及预防［J］.西南医科大学学报,2019,42(4):303-307. ZHU JQ,ZHAO WJ,SU AP.Postoperative complications and prevention of thyroid surgery ［J］.Journal of Southwest Medical University,2019,42(4):303-307.
［4］ 林贝,周天晗,周力,等.甲状腺乳头状癌甲状腺全切除术后甲状旁腺功能减退的影响因素及恢复时间分析［J］.浙江医学,2023,45(10)：1030-1035. LIN B,ZHOU TH,ZHOU L,et al.Analysis of influencing factors and recovery time of parathyroid dysfunction after total thyroidectomy for papillary thyroid cancer ［J］.Zhejiang Medical Journal,2023,45(10):1030-1035.
［5］ 王慧，周乐，孙辉.细针穿刺洗脱液检测在甲状腺和甲状旁腺外科应用进展［J］.中华内分泌外科杂志,2018,12(2):163-165. WANG H,ZHOU L,SUN H.Progress in the application of fine needle aspiration elution detection in thyroid and parathyroid surgery ［J］.Chinese Journal of Endocrine Surgery,2018,12(2):163-165.
［6］ 冯传波，邵华，王钟林.利多卡因联合亚甲蓝在甲状腺手术中的甲状旁腺功能保护作用［J］.国际医药卫生导报,2021,27(19):2996-3000. FENG CB,SHAO H,WANG ZL.Protective effect of Lidocaine combined with Methylene blue on parathyroid function during thyroid surgery ［J］.International Journal of Medicine and Health,2021,27(19):2996-3000.
［7］ XU L,ZHOU P,ZHUANG DY,et al.Clinical application study of parathyroid autofluorescence in identification of parathyroid gland in thyroid carcinoma surgery［J］.Chin J Endocr Surg,2023,17(1):19-23.
［8］ DONGZ Z,LIU W.Single inferior parathyroid autotransplantation during total thyroidectomy with bilateral central lymph node dissection ［J］.World Journal of Surgical Oncology,2023,21(1):102.
［9］ 兰雨，金壮，张明博，等.甲状腺微小乳头状癌患者射频消融术后生活质量的相关影响因素分析［J］.中国医学科学院学报,2020,42(5):632-639. LAN Y,JIN Z,ZHANG MB,et al.Analysis of related influencing factors on quality of life in patients with thyroid papillary carcinoma after radiofrequency ablation ［J］.Journal of the Chinese Academy of Medical Sciences,2020,42(5):632-639.
［10］ 丁小崇，任书伟，李春霞.预防性中央区淋巴结清扫在甲状腺乳头状癌手术治疗中的应用价值［J］.实用癌症杂志,2019,34(4):590-592. DING XC,REN SW,LI CX.The application value of preventive central lymph node dissection in the surgical treatment of papillary thyroid cancer ［J］.Journal of Practical Cancer,2019,34(4):590-592.
［11］ PI QF,YIN SP,SUN YZ,et al.Study on indocyanine green fluorescence imaging technology for determining parathyroid blood supply during total thyroidectomy ［J］.Chinese Journal of Basic and Clinical Surgery,2022,29(10):1313-1317.
［12］ 李岚,刘畅,肖明,等.预测甲状腺术后发生低钙血症的风险列线图模型建立［J］.重庆医学， 2021，50（3）： 461-465. LI L,LIU C,XIAO M,et al.Establishment of a risk column chart model for predicting hypocalcemia after thyroid surgery ［J］.Chongqing Medical Journal,2021,50(3):461-465.
［13］ 姚京，李晨，田文.甲状腺癌的规范诊治［J］.外科理论与实践,2021,26(6):467-471. YAO J,LI C,TIAN W.Standardized diagnosis and treatment of thyroid cancer ［J］ Surgical Theory and Practice,2021,26(6):467-471.
［14］WU GG,LIAO JW,HUANG LP,et al.Risk factors and prognosis for postoperative hypoparathyroidism in patients with thyroid cancer［J］.Chinese Medical Innovation,2023,20(2):132-136.
［15］ 陈紫巍，仇玉轩，邢志超，等.甲状腺术后甲状旁腺激素下降率对永久性甲状旁腺功能低下的预测价值研究［J］.中华内分泌外科杂志,2022,16(4):406-410. CHEN ZW,QIU YX,XING ZC,et al.The predictive value of the decrease rate of parathyroid hormone after thyroid surgery for permanent hypothyroidism ［J］.Chinese Journal of Endocrine Surgery,2022,16(4):406-410.
［16］ WEI RW,WANG ZH,CHEN YB,et al.Related factors of hypoparathyroidism after thyroid cancer surgery［J］.Chin J Endocr Surg,2023,17(4):435-439.
［17］江志鸿，万玉秋，兰晶，等.全甲切术中甲状旁腺自体移植与原位保留的比较分析［J］.中国血液流变学杂志,2020,30(3):356-357. JIANG ZH,WAN YQ,LAN J,et al.Comparative analysis of parathyroid autotransplantation and in situ preservation in total thyroidectomy ［J］.Chinese Journal of Hemorheology,2020,30(3):356-357.
［18］ QI X,DU J,LIU H,et al.First report of in-situ preservation of a subcapsular parathyroid gland through super-meticulous capsular dissection during robotic radical thyroidectomy［J］.Surg Oncol,2019,28:9-13.
［19］ 张国芬,李腾雁,姜楠,等.甲状腺全切后甲状旁腺功能减退恢复时间及影响因素［J］.中国研究型医院,2021,8(6):45-48. ZHANG GF,LI TY,JIANG N， et al.Recovery time and influencing factors of parathyroid dysfunction after total thyroidectomy ［J］.Chinese Research Hospital,2021,8(6):45-48.

Memo

Memo:
-
Last Update: 1900-01-01