Clinical significance of retrograde inferior parathyroid protection technique based on thymus preservation in thyroid surgery.

IF 3.3 3区医学 Q3 ENDOCRINOLOGY & METABOLISM BMC Endocrine Disorders Pub Date : 2025-01-26 DOI:10.1186/s12902-025-01838-y

Shouyi Yan, Yuhan Chen, Wenxin Zhao, Liyong Zhang, Shaojun Cai

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Abstract

Background: The importance of parathyroid gland preservation in thyroid surgery has been well recognized; however, the rapid identification of the parathyroid gland, particularly the inferior parathyroid gland (IPG), remains challenging. This study aimed to evaluate the effectiveness of retrograde inferior parathyroid protection technique (RIPPT) based on thymus preservation.

Methods: A total of 236 patients were enrolled in this study between August 2019 and December 2020. RIPPT was employed to identify and protect the inferior parathyroid gland (IPG), and its identification rate and the anatomical variations were analyzed. The parathyroid hormone (PTH) and serum calcium levels were compared between patients who underwent IPG orthotopic retention and those who received IPG auto-transplantation, stratified by the anatomical type of the IPG.

Results: In total, the IPG identification rate was 97.88% (231/236), and the auto-transplantation rate was 74.46% (172/231). The anatomical relationship between IPG and thymus was observed in 77.97% of patients (184/236). Additionally, PTH levels were higher in patients with IPG orthotopic retention compared to those with IPG auto-transplantation both on postoperative day 1 (POD1) and at 6 months. PTH levels were also higher in patients with superior parathyroid gland (SPG) and IPG orthotopic retention compared to those who underwent both auto-transplantation procedures.

Conclusion: Retrograde inferior parathyroid protection technique (RIPPT) underscores the importance of protecting inferior parathyroid gland (IPG) in thyroid surgery and has been demonstrated to be effective in the rapid identification and functional preservation of IPG, based on short-term outcomes.

Clinical trial number: Not applicable.

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基于胸腺保留的下甲状旁腺逆行保护技术在甲状腺手术中的临床意义。

背景：甲状旁腺保存在甲状腺手术中的重要性已得到充分认识；然而，快速识别甲状旁腺，特别是下甲状旁腺（IPG），仍然具有挑战性。本研究旨在评估基于胸腺保存的逆行下甲状旁腺保护技术（RIPPT）的有效性。方法：2019年8月至2020年12月，共有236例患者入组。应用RIPPT对下甲状旁腺（IPG）进行识别和保护，并对其识别率和解剖变异进行分析。根据IPG的解剖类型进行分层，比较原位保留IPG和自体移植IPG患者甲状旁腺激素（PTH）和血清钙水平。结果：IPG检出率为97.88%(231/236)，自体移植率为74.46%（172/231）。77.97%的患者（184/236）观察到IPG与胸腺的解剖关系。此外，在术后第1天（POD1）和6个月时，IPG原位保留患者的甲状旁腺激素水平高于IPG自体移植患者。与接受两种自体移植手术的患者相比，具有上甲状旁腺（SPG）和IPG原位保留的患者的甲状旁腺激素水平也更高。结论：逆行下甲状旁腺保护技术（RIPPT）强调了在甲状腺手术中保护下甲状旁腺（IPG）的重要性，并已被证明在基于短期结果的快速识别和功能保存IPG方面是有效的。临床试验号：不适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Endocrine Disorders ENDOCRINOLOGY & METABOLISM-

CiteScore

4.40

自引率

0.00%

发文量

280

审稿时长

>12 weeks

期刊介绍： BMC Endocrine Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of endocrine disorders, as well as related molecular genetics, pathophysiology, and epidemiology.