Abstract
Objective: By comparison and analysis preoperative and postoperative related indicators of the Control group (group A) and Fine-needle aspiration(FNA) rapid intraoperative parathyroid hormone (rIO-PTH) group (group B) .To further explore whether rIO-PTH has a certain value for the intraoperative identification and protection of the parathyroid glands, and reduce the incidence of hypoparathyroidism and hypocalcemia in postoperative. Improve the quality of life of patients with thyroidectomy. Methods: In this study, the patients were divided into group A, group B, with 35 cases in each group. In group B, the suspected parathyroid tissues was aspirated by FNA. Parathyroid gland was identified by the concentration of rIO-PTH in the puncture fluid. In group A, only in the traditional thyroid surgery way. Comparative analysis of postoperative PTH and blood calcium, numbers of intraoperative identification of parathyroid glands, the incidence of hypoparathyroidism and hypocalcemia in postoperative. Results: During the operation, the parathyroid glands were identified, the average of group A was (2.60.3), the average of group B was (3.00.2). There was a statistically significant difference in the average number of parathyroid glands between the two groups (P<0.05). Postoperative blood calcium and PTH levels were decreased in all the two groups, and the differences were statistically significant (p < 0.05) on the 1st, 4th, 7th and 30th day after surgery. The incidence of postoperative hypocalcemia was 28.6% (10/35) in group A and 8.6% (3/35) in group B. The incidence of postoperative hypothyroidism was 37.1% (13/35) in group A and 14.3% (5/35) in group B. The incidence of hypocalcemia and hypothyroidism in the two groups was statistically significant difference (P < 0.05). Conclusion: Fine-needle aspiration (FNA) rapid intraoperative detection of parathyroid hormone (rIO-PTH) can identify parathyroid tissue. rIO-PTH can significantly reduce the excessive reduction of postoperative blood calcium and PTH levels in patients, and effectively reduce the incidence of postoperative hypocalcemia and hypothyroidism. rIO-PTH has high clinical application value in identifying and protecting parathyroid gland in thyroid surgery.
Highlights
In recent years, with the wide application of thyroid ultrasound in examination, the detection rate of thyroid cancer increases year by year,And the incidence of thyroid cancer is on the rise, the incidence of women is significantly higher than that of men[1].Thyroid cancer is the most common malignant tumor of thyroid, accounting for about 1% of all malignant tumors
Recent reports have stated that rapid intraoperative parathyroidhormonelevels from tissue fine needle aspiration (FNA) may identify in parathyroid tissues,and it is a simple and convenient new method[7, 8].In this study, rapid intraoperative parathyroid hormone (rIO-PTH) assay of suspected parathyroid tissue was performed using Fine-needle aspiration (FNA) to identify the parathyroids during thyroidectomy, the feasibility of this method is further verified
The incidence of ectopic parathyroid is less than 1%, while ectopic parathyroid is most commonly located in the anterior or posterolateral surface of the hypothyroid gland, about 39% of which is located in the thyroid thymus ligament, about 15% in the carotid sheath, and about 2% in the thymus and pericardium[9, 10]. 80% of the blood supply of the upper parathyroid gland comes from the ascending branch of the inferior thyroid artery, and some of it comes from the anastomotic branch between the superior thyroid artery and the inferior thyroid artery
Summary
With the wide application of thyroid ultrasound in examination, the detection rate of thyroid cancer increases year by year,And the incidence of thyroid cancer is on the rise, the incidence of women is significantly higher than that of men[1].Thyroid cancer is the most common malignant tumor of thyroid, accounting for about 1% of all malignant tumors. Hypoparathyroidism (HPT) has become one of the important complications of thyroid surgery. HPT may leading to the occurrence of hypocalcemia. Patients need long-term calcium and vitamin D supplements after surgery[4]. This postoperative complication seriously affects the postoperative quality of life and brings inconvenience and pain to patients. It is important to identify and protect the parathyroid gland during operation. In situ parathyroid protection technology is the most important, simple and widely used parathyroid protection technology at. Study on Rapid Intraoperative Parathyroid Hormone to Identify and Protect Parathyroid Gland during Total Thyroidectomy present, but it relies too much on the personal experience of the surgeon[5, 6]. Recent reports have stated that rapid intraoperative parathyroidhormone (rIO‐PTH)levels from tissue fine needle aspiration (FNA) may identify in parathyroid tissues,and it is a simple and convenient new method[7, 8].In this study, rIO-PTH assay of suspected parathyroid tissue was performed using FNA to identify the parathyroids during thyroidectomy, the feasibility of this method is further verified
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