[In situ preservation of parathyroid glands in total or near total thyroidectomy].
OBJECTIVE
To investigate the preservation of parathyroid glands and its function during total or near-total thyroidectomy.


METHODS
One hundred and thirty one patients underwent total thyroidectomy, near total thyroidectomy, hemithyroidectomy and isthmectomy. In operation, the parathyroid glands were exposed, or were identified under microscope when necessary. The third rank of inferior thyroid arteries was ligated to preserve parathyroid glands in situ, and the parathyroid function was observed after thyroidectomy.


RESULTS
Four patients (3%) had a transient hypoparathyroidism after thyroidectomy, 26 patients (20%) had a obviously biochemical hypocalcemia with no symptoms, 73 patients (56%) had a lower calcium level in the first 3 days after surgery compared with preoperative level, 28 (21%) patients who underwent ipsilateral total and contralateral subtotal isthmectomy were all normocalcemic after surgery. There were no permanent hypoparathyroidism and death in our study population.


CONCLUSIONS
In total or near-total thyroidectomy, parathyroid glands and its artery blood-supply should be exposed and preserved. Vasodilator and calcium supplementation should be given to patients with obviously lower serum calcium level after surgery to prevent permanent hypoparathyroidism.
Yan
Liying
L
Department of Otolaryngology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China. yly_ent@163.com
Li
Suiqin
S
Zhang
Shaoqiang
S
Bai
Yanxia
Y
Quan
Fang
F
Zhao
Ruimin
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013961:Thyroid Gland / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D055815:Young Adult