Protection Of Parathyroid Grand In Thyroid Cancer Radical Dissection

Objective：Hypoparathyroidism is the most common complication afterthyroidectomy.The study is to explore the impact of parathyroid grandfunction in thyroid cancer radical dissection,and to summarized the techniqueto preserve the parathyroid grand in thyroid surgery.Methods：A total of315subjects were enrolled into this retrospective studyand were classified into three groups: group A， hemithyroidectomy plusipsilateral lymph nodes dissection at the central neck area (n=62); group B，total thyroidectomy plus unilateral lymph nodes dissection at neck IV area(n=193); group C，total thyroidectomy plus bilateral neck VI dissections(n=60). Serum parathyroid hormone (PTH) and calcium were tested beforeand after surgery.Results： In each group, postoperative serum level of parathyroidhormone (PTH) and calcium was significantly decreased than thepreoperative (p<0.05). Compared with hemithyroidectomy plus ipsilateralcentral compartment lymph node dissection,total thyroidectmy plus unilateralor bilateral central compartment lymph node dissection resulted in moredramatic decreases of serum concentration of PTH and calcium and high incidence of low serum PTH,hypocalcemia,symptomatic hypocalcemia(p<0.05).Conclusion：The function of parathyroid can be affected by thyroidoperations． The possibility of postoperative hypoparathyroidism will behigher as the operation range is wider．The key of prevention on postoperativehypoparathyroidism is responsibility of surgeons,intraoperative finehandling，careful checking and attention to the protection of the parathyroidarteries and veins． We need to follow the situ preservation operationprinciple，otherwise it can be supplemented by auto-transplant.