June Young Choi1,2, Hyeong Won Yu1, In Eui Bae1, Jong-Kyu Kim3, Chan Yong Seong3, Jin Wook Yi3, Young Jun Chai4,2, Su-Jin Kim3,2, Kyu Eun Lee3,2. 1. Department of Surgery, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea. 2. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. 3. Department of Surgery, Seoul National University Hospital and College of Medicine, Jongno-gu, Seoul, Korea. 4. Department of Surgery, Seoul National University Boramae Medical Center, Dongjak-gu, Seoul, Korea.
Abstract
BACKGROUND: Saving the parathyroid gland during thyroidectomy remains challenging. Subcapsular saline injection (SCASI) was developed in February 2015. Its ability to spare the parathyroid gland was assessed. METHODS: All consecutive patients who underwent total thyroidectomy with or without neck lymph node dissection in 2013-2015 were included in this retrospective cohort study. Patients were divided into the SCASI and non-SCASI groups. Serum parathyroid hormone (PTH) levels were measured on day 1 and 6 months after surgery. Transient and permanent hypoparathyroidism were defined as day 1 and 6 month PTH < 10.0 and <15.0 pg/mL, respectively. RESULTS: The groups (both had 98 patients each) did not differ in demographics, tumor size, operation extent, pathology, thyroiditis rate, and incidental parathyroid gland excision rate. Compared with non-SCASI patients, patients who underwent the SCASI method exhibited transient hypoparathyroidism (35.7% vs 19.4%, P < .001) and permanent hypoparathyroidism (4.1% vs 0%, P = .043) significantly less frequently. CONCLUSION: The procedure of SCASI effectively spared the parathyroid gland during thyroidectomy.
BACKGROUND: Saving the parathyroid gland during thyroidectomy remains challenging. Subcapsular saline injection (SCASI) was developed in February 2015. Its ability to spare the parathyroid gland was assessed. METHODS: All consecutive patients who underwent total thyroidectomy with or without neck lymph node dissection in 2013-2015 were included in this retrospective cohort study. Patients were divided into the SCASI and non-SCASI groups. Serum parathyroid hormone (PTH) levels were measured on day 1 and 6 months after surgery. Transient and permanent hypoparathyroidism were defined as day 1 and 6 month PTH < 10.0 and <15.0 pg/mL, respectively. RESULTS: The groups (both had 98 patients each) did not differ in demographics, tumor size, operation extent, pathology, thyroiditis rate, and incidental parathyroid gland excision rate. Compared with non-SCASI patients, patients who underwent the SCASI method exhibited transient hypoparathyroidism (35.7% vs 19.4%, P < .001) and permanent hypoparathyroidism (4.1% vs 0%, P = .043) significantly less frequently. CONCLUSION: The procedure of SCASI effectively spared the parathyroid gland during thyroidectomy.
Authors: Hyeong Won Yu; In Eui Bae; Jin Wook Yi; Joon-Hyop Lee; Su-Jin Kim; Young Jun Chai; June Young Choi; Kyu Eun Lee Journal: Surg Today Date: 2019-01-02 Impact factor: 2.549