Heineman Thomas E, Kadkade Prajoy, Kutler David I, Cohen Marc A, Kuhel William I
Weill Cornell Medical College, New York, New York, USA.
Hofstra North Shore-Long Island Jewish School of Medicine, Department of Otolaryngology & Communicative Disorders, North Shore-Long Island Jewish Medical Center, Manhasset, New York, USA.
Otolaryngol Head Neck Surg. 2015 Jun;152(6):1024-8. doi: 10.1177/0194599815578105. Epub 2015 Apr 6.
The feasibility of parathyroid preservation during thyroidectomy has not been well documented for cases in which the thyroid gland extends into the mediastinum.
Retrospective chart review.
Tertiary academic referral center.
In this retrospective cohort study, 70 consecutive patients who had substernal thyroid glands treated with a transcervical thyroidectomy between 1993 and 2013 were compared with 286 thyroidectomies that did not entail substernal extension within that same time period. All localized parathyroid glands were confirmed histologically.
Of 160 possible parathyroid glands in the substernal cases, 119 (74%) were histologically confirmed intraoperatively (67 superior and 52 inferior). In nonsubsternal cases, 725 (89%) were histologically confirmed (372 superior and 353 inferior). There was a statistically significant difference between the substernal and nonsubsternal cases in the total number of glands found (P < .0001) and the number of superior and inferior glands that were identified (P = .009 and < 0.0001).
Even when the thyroid gland extends into the mediastinum, it is often possible, although with reduced efficiency, to identify and preserve the parathyroid glands.
对于甲状腺延伸至纵隔的病例，甲状腺切除术中保留甲状旁腺的可行性尚未得到充分记录。
回顾性病历审查。
三级学术转诊中心。
在这项回顾性队列研究中，将1993年至2013年间连续接受经颈甲状腺切除术治疗的70例胸骨后甲状腺患者与同期进行的286例无胸骨后延伸的甲状腺切除术进行比较。所有定位的甲状旁腺均经组织学证实。
在胸骨后病例的160个可能的甲状旁腺中，119个（74%）在术中经组织学证实（67个为上甲状旁腺，52个为下甲状旁腺）。在非胸骨后病例中，725个（89%）经组织学证实（372个为上甲状旁腺，353个为下甲状旁腺）。胸骨后病例和非胸骨后病例在发现的甲状旁腺总数（P <.0001）以及识别出的上、下甲状旁腺数量（P =.009和< 0.0001）方面存在统计学显著差异。
即使甲状腺延伸至纵隔，通常也有可能识别并保留甲状旁腺，尽管效率会降低。
