Parathyroid protection in surgery of bilateral papillary thyroid cancer

Abstract

To evaluate the protection of parathyroid glands in bilateral papillary thyroid cancer patients who underwent total thyroidectomy and bilateral central compartment dissection. The clinical data of 78 patients undergoing total thyroidectomy and bilateral central compartment dissection between May 2013 and May 2014 were analyzed retrospectively. Among 78 patients, 131 superior parathyroid glands were protected in situ, among those, 112 parathyroid glands located at the level of inferior edge of parathyroid cartilage; 19 parathyroid glands located in the superior 1/3 part of the back sides of the thyroid glands. All the superior parathyroid glands located in the superior and lateral-superior part of the 2 cm part down from the entrance of recurrent laryngeal nerve. A total of 110 inferior parathyroid glands were protected in situ, among those, 57 glands located in the superior of inferior thyroid artery; 24 glands located just on the surface of inferior thyroid artery; 29 glands located below the superior of inferior thyroid artery. Three parathyroid glands were found in the dissected tissues and were implanted immediately. Seven parathyroid glands were found with post-operative pathologic examinations. During surgery, four parathyroid glands was found in 27 patients, three in 30 patients, two in 16 patients, and one in 5 patients. For papillary thyroid cancer patients who underwent total thyroidectomy and bilateral central compartment dissection, identification of parathyroid glands and protection of blood supply to glands are the most effective methods to prevent hypoparathyroidism.