Parathyroid autotransplantation at a novel site for better evaluation of the grafted gland function: study protocol for a prospective, randomized controlled trial

Cui, Qiuxia; Kong, Deguang; Li, Zhihua; Wang, Kun; Zhang, Dan; Tang, Jianing; Liao, Xing; Yuan, Qianqian; Gong, Yan; Wu, Zeyu

doi:10.1186/s13063-019-3195-9

Cited by 8 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For patients with hoarseness, an indirect laryngoscopy was programmed at 1, 3 and 6 months postoperatively, respectively, until the vocal cords function. After 6 months recurrent paralysis is considered permanent [20][21][22][23][24].…”

Section: Resultsmentioning

confidence: 99%

Hypocalcemia after Thyroidectomy for Advanced Local Malignancies

Grigorovici¹,

Varcus²,

Mogos³

et al. 2019

Rev. Chim.

View full text Add to dashboard Cite

Postoperative hypoparathyroidism is most commonly caused by the extirpation, injury or devascularisation of parathyroid glands. The aim of this study is to establish correlations between the advanced thyroid cancer staging, the appropriate individual treatment, the results obtained, the frequency and intensity of transient and/or permanent post-operative hypocalcemia. The present study can be continued with further researches in order to improve and develop surgical, oncological and endocrine management protocols for patients diagnosed with advanced thyroid cancer and also to avoid these relatively frequent and important complications.

show abstract

Section: Resultsmentioning

confidence: 99%

Hypocalcemia after Thyroidectomy for Advanced Local Malignancies

Grigorovici¹,

Varcus²,

Mogos³

et al. 2019

Rev. Chim.

View full text Add to dashboard Cite

show abstract

“…( 31 ) confirmed the survival of transplanted parathyroid glands by subcutaneous transplantation of parathyroid glands in the forearm and observed that serum parathyroid hormone levels were two to three times higher on the transplanted side than on the non-transplanted side. A prospective study compared postoperative parathyroid hormone concentrations in transplanted and non-transplanted forearms by injection at a new subcutaneous site close to the cephalic arm vein to provide a more precise method to confirm the success of parathyroid transplantation ( 32 ). The author believes that the simplest, most direct, and effective way to determine whether a transplanted parathyroid gland is viable is to determine whether PTH concentrations in the reflux venous blood at the transplanted parathyroid gland are higher than those in the venous blood of the body circulation; this would demonstrate the presence of a source of parathyroid hormone secretion at the transplantation site.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of parathyroid autotransplantation in endoscopic total thyroidectomy with CLND

Cheng

Chen

2023

Front. Endocrinol.

View full text Add to dashboard Cite

PurposeTo evaluate the safety and efficacy of autologous parathyroid transplantation in laparoscopic total thyroidectomy combined with central lymph node dissection (CLND).MethodsRetrospective analysis of clinical data of 152 patients admitted to the General Surgery Department of Gansu Provincial People’s Hospital who underwent endoscopic total thyroidectomy combined with CLND from June 2018 to December 2021. The intraoperative parathyroid glands were divided into the orthotopic preservation group (non-transplantation group) and the immediate active autologous transplantation group (transplantation group) according to the different treatment management of parathyroid glands during operation. The levels of Ca2+ in parathyroid blood and the incidence of hypoparathyroidism were compared between the two groups before operation and 1 day, 3 day, 1 week, 1 month, 3 months and 6 months after operation.ResultsThere was no significant difference in PTH between the preoperative transplantation group compared and the non-transplantation group (P>0.05); The PTH in the transplantation group was lower than that of the non-transplantation group 1 and 3 d after surgery, and the difference was statistically significant (P<0.05); No statistically significant difference in PTH between patients in the transplantation group compared with those in the non-transplantation group at 1 week postoperatively (P>0.05); PTH was significantly higher in the transplant group than in the non-transplant group at 1, 3 and 6 months after surgery, with statistically significant differences (P<0.05); there was no statistically differences (P>0.05) in serum Ca2+ between the preoperative, 1d, 3d and 1 week postoperative transplantation group and the non-transplantation group; Blood Ca2+ was significantly higher in the transplant group than in the non-transplant group at 1, 3 and 6 months after surgery, with statistically significant differences (P<0.05); The rate of temporary hypoparathyroidism in the transplantion group was higher than that in the non-transplantion group, and the rate of permanent hypoparathyroidism was lower than that in the non-transplantion group (P=0.044); There was no significant difference in the concentration of PTH in the cephalic vein of the elbow between the transplanted side and the non-transplanted side at 1 day and 3 days postoperatively (P>0.05); the concentration of PTH in cephalic vein of the elbow was significantly higher than that in non-transplanted side at 1 week, 1 month, 3 months and 6 months postoperatively (P<0.001); the number central area dissection and metastasis dissection in the transplantation group were significantly higher than those in the non-transplantation group (P<0.05).ConclusionsMost autologous parathyroid glands, having functional parathyroid autograft, is helpful to the occurrence of hypoparathyroidism after endoscopic total thyroidectomy with CLND, and it is an effective strategy to prevent permanent hypoparathyroidism, and more thorough area dissection is beneficial to the disease prognosis.

show abstract

“…Currently, parathyroid function after thyroid surgery is evaluated using clinical symptoms and serum PTH and calcium concentrations ( 33 ). In previous studies, the sternocleidomastoid muscle was selected as the graft site to avoid making a second surgical incision; however, this method precludes differentiating parathyroid function in the transplantation site and the preserved parathyroid glands ( 34 , 35 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical application of parathyroid autotransplantation in endoscopic radical resection of thyroid carcinoma

Zhang

Wang

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

PurposeThis study aimed to examine the effect of selective inferior parathyroid gland autotransplantation on central lymph node dissection(CLND) and incidence of postoperative hypoparathyroidism in patients undergoing endoscopic radical resection of thyroid carcinoma.MethodsThe data of 310 patients undergoing endoscopic radical resection of thyroid carcinoma will be retrospectively analyzed. The patients will be divided into the experimental group and the control group according to whether they combined with parathyroid autotransplantation. Statistics of the incidence rate of postoperative hypoparathyroidism, the concentration of PTH and Calcium in the systemic circulation at different time points in the two groups, the concentration of PTH in the cubital fossa vein in the transplantation region in the experimental group, and the number of central lymph nodes and positive lymph nodes dissection will be carried out.ResultsThe incidence rate of temporary and permanent hypoparathyroidism in the experimental group was 33.75% and 0.625%, respectively, and in the control group was 22% and 5%, respectively; its difference was statistically significant (X2 = 10.255, P=0.006). Parathyroid autotransplantation increased incidence of transient hypoparathyroidism (OR, 1.806; Cl, 1.088-2.998; P=0.022), and lower incidence of permanent hypoparathyroidism (OR, 0.112; Cl, 0.014-0.904; P=0.040). The diameters of thyroid cancer nodules was not associated with the occurrence of transient hypoparathyroidism (OR, 0.769; Cl, 0.467-1.265; P=0.301) or permanent hypoparathyroidism (OR, 1.434; Cl, 0.316-6.515; P=0.641). Comparison of systemic circulation PTH, between the two groups showed that the PTH of patients in the experimental group was higher than that in the control group from 1 week to 12 months after the operation, and the difference was statistically significant (P<0.05). In the experimental group, from 1 week to 12 months after surgery, PTH concentrations was significantly higher in the cubital fossa of the transplantation side than in the contralateral side, and the differences were statistically significant (P<0.05). The mean number of central lymph node dissected per patient was significantly higher in the experimental group (7.94 ± 3.03 vs. 6.99 ± 2.86; P <0.05); The mean number of positive nodes per patient was significantly higher in the experimental group (3.16 ± 1.86 vs. 2.53 ± 1.59; P <0.05).ConclusionsIn endoscopic radical resection of thyroid carcinoma, parathyroid autotransplantation is more beneficial to postoperative parathyroid glands function recovery, effectively preventing postoperative permanent hypoparathyroidism and realizing more thorough CLND.

show abstract

Parathyroid autotransplantation at a novel site for better evaluation of the grafted gland function: study protocol for a prospective, randomized controlled trial

Cited by 8 publications

References 23 publications

Hypocalcemia after Thyroidectomy for Advanced Local Malignancies

Hypocalcemia after Thyroidectomy for Advanced Local Malignancies

Efficacy of parathyroid autotransplantation in endoscopic total thyroidectomy with CLND

Clinical application of parathyroid autotransplantation in endoscopic radical resection of thyroid carcinoma

Contact Info

Product

Resources

About