Application Of New Parathyroid Gland Classifications In Open Thyroid Carcinoma Surgery

Objective:Hypoparathyroidism is a frequent complication of thyroidectomy,especially in thyroid carcinoma surgery. Postoperative hypocalcemia isthe most common clinical symptom of hypoparathyroidism, such asweakness、paralysis around lips、limbs ache and tetany. Laryngospasmand arrhythmia are urgent clinical symptoms of hypoparathyroidism,which can threaten to patient’s life. So how to reserve parathyroid glandseffectively, how to reduce damage of functions and incidence ofhypoparathyroidism are difficult dilemmas to surgeons all over the world.This paper starts from anatomy of parathyroid glands, updatingparathyroid gland classifications in more details, which is based onpresent classifications,studying damage reasons of each classification inopen thyroid carcinoma surgery, discussing effective strategies ofparathyroid glands protecting in surgery. In order to avoiding damage bymistake in surgery, cutting down the incidence of hypoparathyroidismafter open thyroid carcinoma surgery.Methods:Data of154cases, which37cases are male and female are117,treated with open thyroid carcinoma surgery from March1,2013toSeptember30,2014were retrospectively reviewed. Age range from22to77, mean age was45.56. There were152confirmed cases of papillarythyroid carcinoma,1confirmed cases of medullary thyroid carcinoma and 1confirmed cases of anaplastic thyroid cancer. Protection with newparathyroid gland classifications was named as improving protectingstrategies, and if were not, it was named as traditional protectingstrategies. team A had67cases of thyroid carcinoma since March1,2013to December31,2013,who were applied with traditional protectingstrategies. And team B had87cases of thyroid carcinoma since January1,2014to September30,2014,who were applied with improvingprotecting strategies. Ca2+and albumin in serum had been measured aftersurgery(24h~72h), to known about incidence of hypoparathyroidism(contains transient hypoparathyroidism and permanent hypoparathyroidism).Statistic analysis was performed with SPSS18.0Chinese statistical software.Evaluated efficiency of protecting strategies.Results:There were24patients who had hypocalcemia in team A, theincidence was35.82%. And there were15patients who had hypocalcemiain team B, the incidence was17.24%. The differences had significantstatistical significance.Conclusion:Improving protecting strategies, which are applied to open thyroidcarcinoma surgery with new parathyroid gland classifications, can cutdown the incidence of hypoparathyroidism, no matter transienthypoparathyroidism or permanent hypoparathyroidism.