[Effect of protecting parathyroid in situ in the operation of total thyroidectomy].
OBJECTIVE
To evaluate the effect of protecting parathyroid glands in situ in the operation of total thyroidectomy by detecting parathyroid hormone after the operation.


METHODS
In the surgical team, 1019 consecutive patients with thyroid diseases were treated with total thyroidectomy. During the operation, parathyroid glands were protected in situ with correctly identifying the parathyroid glands, precisely dissecting its envelope and protecting its blood supply. Serum calcium level and parathyroid hormone were measured before and 24 hours after operation. The patients who had symptomatic hypocalcemia or hypoparathyroidism were given supportive treatment and followed-up.


RESULTS
At least one of the parathyroid glands was preserved and remained in situ in all cases. Eighty-nine cases (8.7%) had decreased parathyroid hormone levels and 42 cases (4.1%) had complicated symptomatic hypocalcemia. The symptoms of hypocalcemia in all these cases could be controlled by supportive treatment, and serum calcium level and parathyroid hormone had all recovered 1 - 6 months later. If 3 and 4 parathyroid were conserved in situ, the postoperative complication rate was significantly lower than those with 1 and 2 parathyroid conserved (decreased PTH 69/999 vs 20/20, symptoms of hypocalcemia 25/999 vs 17/20, all P < 0.01).


CONCLUSIONS
The techniques to protect parathyroid glands in situ are effective measure to prevent the postoperative hypoparathyroidism in total thyroidectomy.
Wu
Gao-song
GS
Department of Breast and Thyroid Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Ma
Xiao-peng
XP
Liu
Jie
J
Liu
Yan-yan
YY
Wang
Jie
J
Huang
Li-li
LL
Yin
Yu-ping
YP
Yi
Ji-lin
JL
Zou
Sheng-quan
SQ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000517:prevention & control; D007011:Hypoparathyroidism / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000098:blood supply / Q000601:surgery*; D010281:Parathyroid Hormone / Q000097:blood*; D011183:Postoperative Complications / Q000517:prevention & control; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
D010281:Parathyroid Hormone; D002118:Calcium