S Ander1, K Johansson, S Smeds. 1. Department of Surgery Norra Alvsborgs Länssjukhus. Trollháttan, Sweden.
Abstract
OBJECTIVE: To study the microcirculation of the parathyroids before and after dissection during operations on the thyroid gland to see if there were better ways of preserving them. DESIGN: Prospective open study. SETTING: University hospital, Sweden. SUBJECTS: 16 Patients undergoing operations on the thyroid gland. 20 Parathyroid glands located anteriorly on the thyroid lobe were selected for study. INTERVENTIONS: Recording of microcirculation of the parathyroids with laser Doppler flowmetry. Recording of the macroscopic appearance of the parathyroid glands. MAIN OUTCOME MEASURES: Correlation between reduction in blood flow and the macroscopic appearance of glands while they were ischaemic. RESULTS: Parathyroid microcirculation before dissection gave a mean Doppler signal level of 4.6 (1.4) V. 30 minutes after dissection to preserve the gland the remaining mean (SD) signal was 37 (24)% of the initial level. At the end of the operation the microcirculation tended to recover about 46 (21)% of the original value (p = 0.33). The macroscopic appearance of the gland during the ischaemic period did not correlate well with the reduction in blood flow. CONCLUSION: During dissection to preserve normal parathyroid glands there was a discrepancy between the macroscopic appearance and changes in the microcirculation. The microcirculation recovers and this can be verified by laser Doppler flowmetry.
OBJECTIVE: To study the microcirculation of the parathyroids before and after dissection during operations on the thyroid gland to see if there were better ways of preserving them. DESIGN: Prospective open study. SETTING: University hospital, Sweden. SUBJECTS: 16 Patients undergoing operations on the thyroid gland. 20 Parathyroid glands located anteriorly on the thyroid lobe were selected for study. INTERVENTIONS: Recording of microcirculation of the parathyroids with laser Doppler flowmetry. Recording of the macroscopic appearance of the parathyroid glands. MAIN OUTCOME MEASURES: Correlation between reduction in blood flow and the macroscopic appearance of glands while they were ischaemic. RESULTS: Parathyroid microcirculation before dissection gave a mean Doppler signal level of 4.6 (1.4) V. 30 minutes after dissection to preserve the gland the remaining mean (SD) signal was 37 (24)% of the initial level. At the end of the operation the microcirculation tended to recover about 46 (21)% of the original value (p = 0.33). The macroscopic appearance of the gland during the ischaemic period did not correlate well with the reduction in blood flow. CONCLUSION: During dissection to preserve normal parathyroid glands there was a discrepancy between the macroscopic appearance and changes in the microcirculation. The microcirculation recovers and this can be verified by laser Doppler flowmetry.
Authors: Emmanuel A Mannoh; Giju Thomas; Naira Baregamian; Sarah L Rohde; Carmen C Solórzano; Anita Mahadevan-Jansen Journal: Thyroid Date: 2021-08-18 Impact factor: 6.506