유두갑상선암의 고식적 갑상선전절제술과 내시경하 갑상선전절제술 후 부갑상선 보존율 비교분석

김정빈; 박인석; 조현진; 곽금희; 양근호; 배병노; 김기환; 한세환

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자료유형: 학술저널

저자정보: 김정빈 박인석 조현진 곽금희 양근호 배병노 김기환 한세환

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제12권 제2호

발행연도: 2012.1

수록면: 98 - 101 (4page)

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Purpose: Incidental parathyroidectomy is the most common and unexpected consequence of a total thyroidectomy. It can cause hypocalcemia symptoms such as muscle cramping and even seizures. We conducted this study to compare several factors including the preservation rate of parathyroid glands during both a bilateral axillo-breast approach endoscopic thyroidectomy (BABA) and a conventional open thyroidectomy (CT) for papillary thyroid carcinomas. Methods: We retrospectively reviewed the medical records of 299 papillary thyroid cancer patients who had a total thyroidectomy between January 2008 and December 2011. We grouped the patients into two groups: BABA (n=70) and CT (n=229). We analyzed age, tumor size, operation time, the number of preserved and removed parathyroid glands, amount and duration of seroma drainage, pain score, hypocalcemia symptoms, and serum total calcium level in both the BABA and CT groups. Results: We observed a younger age (under 45 years old) (P=0.000), smaller tumor size (P=0.000), longer operation time (P=0.000), larger amount of drainage (P=0.000), longer duration of drainage (P=0.007), and larger pain score (P=0.000) in the BABA group. Of the 70 patients that received an endoscopic thyroidectomy, we preserved all four parathyroid glands in 56 patients (78.6%). Of the 229 patients that received an open thyroidectomy, we preserved all four parathyroid glands in 141 patients (61.6%, P=0.004). Conclusion: BABA results in more extensive tissue damage over a longer period of time than CT. However, BABA was an excellent method for preserving parathyroid glands when compared with CT for thyroid carcinoma. Thus, it seems to be feasible performing BABA when it matches the indications.

#내시경 #저칼슘혈증 #부갑상선저하증 #부갑상선 #갑상선전절제술 #Endoscopic #Hypocalcemia #Hypoparathyroidism #Parathyroid #Total thyroidectomy

참고문헌 (26)

참고문헌 신청

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

Choi JY / 201204 / Endoscopic thyroidectomy via bilateral axillo-breast approach (BABA): review of 512 cases in a single institute / SURGICAL ENDOSCOPY AND OTHER INTERVENTIO

Chung YS / 2007 / Endoscopic thyroidectomy for thyroid malignancies: comparison with conventional open thyroidectomy / World J Surg 31 : 2302 ~ 2306

Duh QY / 2003 / Presidential Address: minimally invasive endocrine surgery--standard of treatment or hype? / Surgery 134 : 849 ~ 857

Duncan TD / 2009 / Transaxillary endoscopic thyroidectomy: an alternative to traditional open thyroidectomy / J Natl Med Assoc 101 : 783 ~ 787