In situ preservation of the parathyroid glands during operations on the Thyroid.
OBJECTIVE
To study the microcirculation of the parathyroids before and after dissection during operations on the thyroid gland to see if there were better ways of preserving them.


METHODS
Prospective open study.


METHODS
University hospital, Sweden.


METHODS
16 Patients undergoing operations on the thyroid gland. 20 Parathyroid glands located anteriorly on the thyroid lobe were selected for study.


METHODS
Recording of microcirculation of the parathyroids with laser Doppler flowmetry. Recording of the macroscopic appearance of the parathyroid glands.


METHODS
Correlation between reduction in blood flow and the macroscopic appearance of glands while they were ischaemic.


RESULTS
Parathyroid microcirculation before dissection gave a mean Doppler signal level of 4.6 (1.4) V. 30 minutes after dissection to preserve the gland the remaining mean (SD) signal was 37 (24)% of the initial level. At the end of the operation the microcirculation tended to recover about 46 (21)% of the original value (p = 0.33). The macroscopic appearance of the gland during the ischaemic period did not correlate well with the reduction in blood flow.


CONCLUSIONS
During dissection to preserve normal parathyroid glands there was a discrepancy between the macroscopic appearance and changes in the microcirculation. The microcirculation recovers and this can be verified by laser Doppler flowmetry.
Ander
S
S
Department of Surgery Norra Alvsborgs Länssjukhus. Trollháttan, Sweden.
Johansson
K
K
Smeds
S
S
D000328:Adult; D005260:Female; D006801:Humans; D007511:Ischemia / Q000473:pathology; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation; D010280:Parathyroid Glands / Q000098:blood supply* / Q000473:pathology / Q000637:transplantation; D011183:Postoperative Complications; D011446:Prospective Studies; D013959:Thyroid Diseases / Q000601:surgery; D014182:Transplantation, Autologous