The Impact of Different Thyroid Surgery Routes on the Function of Parathyroid.

To explore the impact of three different surgery routes for thyroid cancer on the function of parathyroid.Three groups were included: group A-gland lobe removal of one side + ipsilateral lymph nodes dissection at the central neck area (n = 62); group B-total thyroid removal + unilateral lymph nodes dissection at neck IV area with/without ipsilateral dissection of neck II-V area (n = 193); group C-total thyroid removal + bilateral neck VI dissections with/without lymph nodes dissection of ipsilateral neck II-V area (n = 60). Serum parathyroid hormone (PTH) and calcium were tested before and after surgery.For all groups, both PTH and calcium levels dropped after surgery. There is no difference for serum PTH and calcium one or four days after surgery between group B and C. Group A had much lower incidence of hypocalcaemia or hypoparathyroidism, compared B or C (p < 0.05). In group A, artery and recurrent vein of parathyroid were spared during the surgery, suggesting the importance of this regard.The larger of surgical area, the higher incidence of hypoparathyroidism. The incidence of hypoparathyroidism can dramatically drop if artery and recurrent vein of parathyroid are spared during surgery, as indicated in gland lobe removal with ipsilateral lymph nodes dissection.