|
|
|
| Effect of Total Thyroidectomy by Total Endoscopic Areola Approach on Parathyroid Function in the Treatment of Thyroid Papillary Carcinoma |
| HOU Yufei, AO Yazhou, QI Yantao |
| The Affiliated Hospital of Chengde Medical University, Hebei Chengde 067000, China |
|
|
|
|
Abstract Objective: To investigate the impact of transareolar endoscopic thyroidectomy on parathyroid function in the treatment of papillary thyroid carcinoma. Methods: Clinical data of 130 patients with bilateral micro papillary thyroid carcinoma who underwent total thyroidectomy from March 2020 to January 2023 at the Affiliated Hospital of Chengde Medical College were collected and retrospectively analyzed. Among them, 30 cases underwent total thyroidectomy with central lymph node dissection through the transareolar route, and 100 cases underwent total thyroidectomy with central lymph node dissection through the traditional neck approach. Serum parathyroid hormone and blood calcium levels were compared between the two groups before surgery and at 1 day, 7 days, 1 month, 3 months, and 6 months after surgery. Results: There was no statistically significant difference in serum parathyroid hormone and blood calcium levels between the two groups before surgery, at 1 day, 7 days, 3 months, and 6 months after surgery (P>0.05). At 1 month after surgery, there was a statistically significant difference in serum parathyroid hormone and blood calcium levels between the two groups (P<0.05), with a greater decrease in the transareolar surgery group (P<0.05). Calcium supplementation was given orally or intravenously after surgery. After 6 months, 4 cases in the transareolar approach group had serum parathyroid hormone levels <15 pg/mL, while 11 cases in the traditional approach group had levels <15 pg/mL. After 6 months, 2 cases in the transareolar approach group had blood calcium levels <2.0 mmoL/L, while 4 cases in the traditional neck approach group had levels <2.0 mmoL/L. Conclusion: For total thyroidectomy, there was no statistically significant difference in the incidence of permanent parathyroid dysfunction between transareolar endoscopic thyroidectomy and traditional open neck approach. For patients with cosmetic needs, transareolar endoscopic thyroidectomy is a safe and effective surgical approach.
|
|
|
|
|
|
[1] 张琪,王泽升,等.腔镜甲状腺癌根治术联合甲状旁腺自体移植术对甲状旁腺功能恢复的影响[J].解放军医学杂志,2023,48(4):437-444.
[2] 中华医学会内分泌学分会、中华医学会外科学分会甲状腺及代谢外科学组等.《甲状腺结节和分化型甲状腺癌诊治指南(第2版)》[J].中华内分泌代谢杂志,2023,39(3):181-226.
[3] 谢波,孙思雨,王彬彬,等.分化型甲状腺癌术后甲状旁腺功能减退风险综合预测模型建立[J].中国实用外科杂志,2021,41(4):443-446.
[4] 王松,张方洁.甲状腺全切除术后甲状旁腺激素水平变化的相关因素分析[J].现代肿瘤医学.2022.30(12)2150-2156.
[5] 李启佳,程若川.甲状旁腺损伤相关的临床解剖学研究与原因分析[J].国际外科学杂志,2022,49(2):140-143.
[6] 马莹,唐梓轩.甲状腺切除术后甲状旁腺功能减退的发生情况及相关因素分析[J]肿瘤预防与治疗,2022,35(8):720-725.
[7] 苏艳军,刘彬,等.甲状腺术中甲状旁腺体外保存后自体移植对其功能影响的研究[J].重庆医学,2017,46(8):1032-1035.
[8] 夏宝莹;木尼热·阿不都外力,等.甲状腺手术中甲状旁腺自体移植及体外保存[J].中国普外基础与临床杂志,2021,28(9):1227-1231.
[9] 赵宁,滕长胜,等.cT1N0甲状腺癌全乳晕入路腔镜手术与开放手术对比研究[J]中华内分泌外科,2020,14(1):18-22.
[10] 侯建忠,张颖超,等.全乳晕腔镜手术与传统开放手术治疗甲状腺癌临床效果的Meta分析[J].腹腔镜外科杂志,2020,25(5):321-327. |
|
|
|
2024, Vol. 30 
