갑상선유두상암종에서 갑상선 전절제술 및 양측 중심 경부청소술 후 보존된 부갑상선의  개수와 임상적 양상과의 상관관계

위찬은; 왕수건; 이병주; 임윤성; 이윤세; 김인주; 김보현; 김상수; 천용일; 이진춘

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자료유형: 학술저널

저자정보: 위찬은 왕수건 이병주 임윤성 이윤세 김인주 김보현 김상수 천용일 이진춘

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제56권 제7호

발행연도: 2013.1

수록면: 431 - 435 (5page)

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Background and Objectives To identify the relation between the preservation status of the parathyroid glands and the risk of hypoparathyroidism after total thyroidectomy and central lymph node dissection in papillary thyroid carcinoma. Subjects and Method A retrospective review was carried out for the medical records of 63 patients with papillary thyroid carcinoma (PTC), who satisfied our inclusion criteria and received treatment at the Department of Otolaryngology-Head and Neck Surgery, Hospital from May 2010 to December 2011. Patients with PTC who underwent total thyroidectomy with central lymph node dissection (CLND) were included and grouped according to the number of preserved parathyroid glands as follows: Group 1 (with four intact glands), Group 2 (three intact glands), Group 3 (less than two intact glands). The total and ionized serum calcium and intact parathyroid hormone levels of each group were monitored after the surgery. Patients with postoperative symptomatic hypocalcemia were considered to have postoperative hypoparathyroidism and received calcium/vitamin D therapy. The hypoparathyroidism was considered to be permanent when calcium/vitamin D therapy was still required six months after surgery. Results Out of 63 cases of total thyroidectomy with CLND, 31 (49.2%) showed postoperative hypoparathyroidism as demonstrated by laboratory findings. Permanent hypoparathyroidism, however, was not observed in these cases. The development of hypoparathyroidism was not significantly related with the number of preserved parathyroid glands. Conclusion To prevent postoperative hypoparathyroidism following total thyroidectomy and CLND, at least two parathyroid glands should be preserved in situ with an intact blood supply in order to prevent permanent hypoparathyroidism after the surgery.

#Hypocalcemia #Parathyroid #Total thyroidectomy.

참고문헌 (10)

참고문헌 신청

Akerstrom G / 1984 / Surgical anatomy of human parathyroid glands / Surgery 95 (1) : 14 ~ 21

Asari R / 2008 / Hypoparathyroidism after total thyroidectomy: a prospective study / Arch Surg 143 (2) : 132 ~ 138

Bentrem DJ / 2001 / Evaluation of serum calcium levels in predicting hypoparathyroidism after total/near-total thyroidectomy or parathyroidectomy / Am Surg 67 (3) : 249 ~ 252

Cheah WK / 2002 / Complications of neck dissection for thyroid cancer / World J Surg 26 (8) : 1013 ~ 1016

Page C / 2003 / The inferior laryngeal nerve: surgical and anatomic considerations. Report of 251 thyroidectomies / Surg Radiol Anat 25 (3-4) : 188 ~ 191