Comparison of parathyroid hormone levels between orthotopic preservation of parathyroid gland and immediate active autotransplantation

Abstract

Objective To compare the effects of in situ parathyroid preservation during total thyroidectomy and immediate active parathyroid transplantation (parathyroid tissue homogenate injection) on the level of parathyroid hormone (PTH) and serum calcium in patients after thyroidectomy. Methods The clinical data of 74 patients undergoing total thyroidectomy were analyzed. The patients were divided into two groups: in situ preservation group (control group) and immediate active autotransplantation group (experimental group) according to the different managements of parathyroid gland during operation. The levels of serum Ca2+ and PTH on day 1, 3, 5, 7 and 30 after operation in the two groups were analyzed. Results There was no significant difference in PTH between the experimental group and the control group (46.2±17.3), (50.6±15.7) pg/ml, before operation (P>0.05). There was no significant difference in serum calcium between the experimental group and the control group (2.21±0.12), (2.17±0.10) mmol/L, before operation (P>0.05). The PTH of the control group was (19.8±7.6), (22.4±9.4), (18.8±8.5) pg/ml, on the 1st 3rd and 5th day after operation, and the PTH, of the experimental group was significantly higher than that of the experimental group (11.7±5.5), (12.6±7.9), (13.5±8.7) pg/ml, had significant difference (P 0.05). The levels of PTH [(16.5±7.5) pg/ml] and serum calcium [(1.85±0.17) mmol/L] in the control group were significantly lower than those in the experimental group [(22.3±8.4) pg/ml and (2.02±0.18) mmol/L], on the 30th day after operation. The difference was statistically significant (P<0.05). Conclusion Immediate active autotransplantation of multiple parathyroid gland is helpful to reduce the hypoparathyroid function after total thyroidectomy, and the injection of parathyroid tissue homogenate is easier to carry out and the effect is better. Key words: Total thyroidectomy; Parathyroid gland autotransplantation; Parathyroid hormone