Xin yixue (Feb 2025)

Application effect of modified in situ parathyroid preservation technique in transoral vestibular endoscopic radical thyroidectomy for thyroid cancer

  • LIU Yanjia, XU Nan, WANG Yuanyang, LUO Xunpeng

DOI
https://doi.org/10.12464/j.issn.0253-9802.2024-0446
Journal volume & issue
Vol. 56, no. 2
pp. 148 – 154

Abstract

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Objective To investigate the application effect of the modified in situ parathyroid preservation technique in transoral vestibular endoscopic radical thyroidectomy for thyroid cancer. Methods A retrospective analysis was carried out on 105 patients who underwent transoral vestibular endoscopic radical thyroidectomy for thyroid cancer at Shenzhen People’s Hospital from January 2020 to January 2024. The control group received traditional in situ preservation or autotransplantation of the inferior parathyroid glands， while the observation group underwent the modified in situ parathyroid preservation technique. The therapeutic effects of the two groups were compared. Results All surgeries were successfully completed in both groups. Preoperative serum calcium and parathyroid hormone （PTH） levels showed no significant differences between the observation and control groups （all P >0.05）. At 24 hours postoperatively， the serum calcium in the observation group was （2.3±0.1） mmol/L， significantly higher than （2.2±0.1） mmol/L in the control group （t = -5.43， P < 0.01）. The PTH levels in the observation group were 18.2 （5.3，28.0） pg/mL， compared to 20.8 （6.8， 27.1） pg/mL in the control group， with no significant difference between the two groups （t = -0.48， P > 0.05）. The blood calcium level in the observation group were higher than those in the control group 24 h after bilateral thyroidectomy combined with central lymph node dissection （P < 0.05）. The incidence of transient hypoparathyroidism was 36.7% （18/49） in the observation group and 50.0% （28/56） in the control group.At 6 weeks postoperatively， the PTH recovery rate in the observation group was 72.2% （13/18）， while the control group had a PTH recovery rate of 68.2% （15/22）. The difference in PTH recovery rates between the two groups was not statistically significant （P > 0.05）. Conclusion In transoral vestibular endoscopic radical thyroidectomy for thyroid cancer， the modified in situ parathyroid preservation technique can prevent hypoparathyroidism and contribute to the improvement of postoperative outcomes for patients.

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