갑상선 절제술 후 부갑상선 기능저하증의 양상 및 부갑상선 자가이식의 효과

정주환; 김태헌; 지용배; 정진혁; 이승환; 박철원; 태경

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자료유형: 학술저널

저자정보: 정주환 김태헌 지용배 정진혁 이승환 박철원 태경

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제56권 제1호

발행연도: 2013.1

수록면: 28 - 33 (6page)

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Background and Objectives To preserve the parathyroid gland during thyroidectomy, understanding of its anatomy and physiology is essential. Parathyroid autotransplantation can be performed to restore the function of parathyroid gland. However, the efficacy of parathyroid autotransplantation is still debatable. The aim of this study was to analyze the frequency of hypoparathyroidism following thyroidectomy and evaluate the efficacy of parathyroid autotransplantation. Subjects and Method We analyzed 449 patients who underwent thyroidectomy from January 2006 to June 2010. A total of 419 patients underwent total thyroidectomy, while 30 patients underwent unilateral lobectomy. Among the total thyroidectomy group, 96 patients underwent unilateral central neck dissection and 186 patients underwent bilateral central neck dissection. We analyzed the frequency of hypoparathyroidism according to the extent of thyroidectomy and central neck dissection, and parathyroid gland autotransplantation. Results Transient hypoparathyroidism occurred in 20% of lobectomy patients and 54.6% of the entire thyroidectomy group. Permanent hypoparathyroidism occurred only in 7.2% of the entire thyroidectomy group. Transient and permanent hypoparathyroidism occurred in 47.4% and 6.5%, respectively, of the patients without central neck dissection, in 54.0% and 7.3%, respectively, of the patients with unilateral central neck dissection, and 60.2% and 7.5%, respectively, of the patients with bilateral central neck dissection. Parathyroid autotransplantation was performed in 29 patients of 105 patients whose one or more parathyroid glands were removed inadvertently, and permanent hypoparathyroidism did not occur among those patients. Conclusion The frequency of transient hypoparathyroidism was increased according to the extent of thyroidectomy and central neck dissection. Parathyroid autotransplantation might be effective in minimizing permanent hypoparathyroidism.

#Central neck dissection #Hypoparathyroidism #Parathyroid autotransplantation #Thyroidectomy

참고문헌 (19)

참고문헌 신청

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Attie JN / 1975 / Preservation of parathyroid glands during total thyroidectomy. Improved technic utilizing microsurgery / Am J Surg 130 (4) : 399 ~ 404

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Carling T / 2010 / Controversy surrounding the role for routine central lymph node dissection for differentiated thyroid cancer / Curr Opin Oncol 22 (1) : 30 ~ 34

Cernea CR / 2010 / How to minimize complications in thyroid surgery? / Auris Nasus Larynx 37 (1) : 1 ~ 5