Abstract
Objective:To evaluate the effects of thyroid cystectomy for primary hyperparathyroidism on immune function.Methods:Ninety-two patients with parathyroid cysts complicated with primary hyperparathyroidism were randomly divided into a treatment group and a control group (n=46). The treatment group received endoscopic thyroidectomy through the anterior chest wall via the areolar approach, and the control group was treated with conventional open thyroidectomy.Results:The two groups had similar immune function indices as well as thyroid hormone, serum calcium and phosphorus levels before surgery (P>0.05). After surgery, FT3 and FT4 levels significantly increased in both groups, whereas that of TSH significantly decreased (P<0.05). The levels of the two groups differed significantly on the postoperative 5th day (P<0.05). NK%, CD3+%, CD4+% and CD8+%, which significantly fluctuated on the postoperative 1st day in both groups (P<0.05), were basically recovered on the postoperative 5th day in the treatment group that had significantly different outcomes from those of the control group (P<0.05). On the postoperative 1st and 5th days, the treatment group had significantly lower serum calcium level and significantly higher serum phosphorus level than those of the control group (P<0.05). The surgeries were successfully performed for all patients. During three months of follow-up, the treatment group was significantly less prone to complications such as surgical site infection, recurrent laryngeal nerve injury, parathyroid crisis and hoarseness than the control group (P<0.05).Conclusion:For treatment of primary hyperparathyroidism, endoscopic thyroidectomy through the anterior chest wall via the areolar approach decreased the incidence rate of complications, as well as promoted the recovery of serum calcium and phosphorous levels, probably by only mildly affecting immune function and thyroid hormone levels.
Highlights
Primary hyperparathyroidism, as a common, frequently occurring disease in clinical practice, mainly endangers young females
We evaluated the effects of two methods for thyroid cystectomy on the immune function of patients with primary hyperparathyroidism
Changes of immunological indices: NK%, CD3+%, CD4+% and CD8+%, which were similar in the two groups before surgery, significantly fluctuated on the postoperative 1st day in both groups (P
Summary
As a common, frequently occurring disease in clinical practice, mainly endangers young females. 2% of thyroid malignancies are developed from benign thyroid diseases which, as suggested by previous evidence, have the tendency to carcinomatous changes.[5,6] Conventional open thyroidectomy has been applied for over one hundred years and improved gradually.[7] On the other hand, totally endoscopic thyroid surgery is available for thyroid cystectomy.[8] Endoscopic thyroidectomy via the areolar approach is conducive to early postoperative recovery by minimizing surgical sites and hiding them distant from the neck as well as by mildly burdening organs and systems.[9] immune function is bound to be disordered after surgery as a special form of trauma. Many immune cells and liquid media are involved in early inflammatory response, forming stress response and leading to poor prognosis as a result.[10,11] In this study, we evaluated the effects of two methods for thyroid cystectomy on the immune function of patients with primary hyperparathyroidism
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