Acta endocrinologica (Bucharest, Romania : 2005) · 2025
A NEW METHOD FOR INTRAOPERATIVE DEFINITIVE DIAGNOSIS OF INADVERTENT PARATHYROIDECTOMY DURING CENTRAL NECK DISSECTION.
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Aysan E, Korkmaz Y Y, Hacihasanoglu E
Аннотация
BACKGROUND: The most serious complication of central neck dissection (CND) is inadvertent parathyroidectomy. There is no definitive method for intraoperative diagnosis of this complication.
METHOD: We studied on CND indicated 17 thyroid cancer patients (14 female, 3 male, age range: 21-67, mean age: 43.4). The excised CND material was kept in 50 ml of normal saline for 30 minutes. A 2 ml sample was taken from this fluid and sent to biochemistry for rapid parathyroid hormone (PTH) measurement.
RESULTS: PTH values were <10pg/mL in 14 patients. PTH values of three patients were very high (112pg/mL, 167pg/mL, 210pg/mL respectively). When the excised tissue in these patients was evaluated intraoperatively with loop glasses, one parathyroid tissue was found in each of the three cases and these were autotransplanted intramuscularly. After this procedure we kept CND tissue material again in another normal saline of 50mL in 30 minutes and PTH was measured. The values came back as <10pg/mL. No parathyroid gland was found in any case in the postoperative routine histopathological evaluation. No patient had symptoms of hypocalcemia during the eight-weeks postoperative follow-up.
CONCLUSION: Inadvertent parathyroidectomy due to CND is a serious complication. This complication can be prevented with the simple method we recommend here.
METHOD: We studied on CND indicated 17 thyroid cancer patients (14 female, 3 male, age range: 21-67, mean age: 43.4). The excised CND material was kept in 50 ml of normal saline for 30 minutes. A 2 ml sample was taken from this fluid and sent to biochemistry for rapid parathyroid hormone (PTH) measurement.
RESULTS: PTH values were <10pg/mL in 14 patients. PTH values of three patients were very high (112pg/mL, 167pg/mL, 210pg/mL respectively). When the excised tissue in these patients was evaluated intraoperatively with loop glasses, one parathyroid tissue was found in each of the three cases and these were autotransplanted intramuscularly. After this procedure we kept CND tissue material again in another normal saline of 50mL in 30 minutes and PTH was measured. The values came back as <10pg/mL. No parathyroid gland was found in any case in the postoperative routine histopathological evaluation. No patient had symptoms of hypocalcemia during the eight-weeks postoperative follow-up.
CONCLUSION: Inadvertent parathyroidectomy due to CND is a serious complication. This complication can be prevented with the simple method we recommend here.