title: In situ preservation of the parathyroid glands during operations on the Thyroid.
abstract: 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.
authors.affiliation: Department of Surgery Norra Alvsborgs Länssjukhus. Trollháttan, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Ander
authors.forename: K
authors.initials: K
authors.lastname: Johansson
authors.forename: S
authors.initials: S
authors.lastname: Smeds
mesh_terms: 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