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小儿甲状旁腺自体移植的结果分析:一项回顾性研究

Outcome Analysis of Parathyroid Gland Auto-transplantation in Pediatric Patients: A Retrospective Review.

作者信息

Lopez Andrea A, Zhao Shilin, O'Brien Kaitlin July, Rohde Sarah, Belcher Ryan H

机构信息

Vanderbilt University School of Medicine, Nashville, TN, USA.

Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.

出版信息

Ann Otol Rhinol Laryngol. 2025 Apr;134(4):249-253. doi: 10.1177/00034894241307530. Epub 2024 Dec 18.

Abstract

Parathyroid gland (PG) auto-transplantation is performed to preserve the function of de-vascularized or unintentionally removed PGs, however, little has been published about the technique and outcomes in children. In our study, we aimed to present the results of PG auto-transplantation in children undergoing thyroidectomy or parathyroidectomy at a tertiary single institution. A retrospective review identified 14 patients (<18 years of age) who underwent PG auto-transplantation from January 2000 to December 2022. 57.1% (8/14) had transient postoperative hypocalcemia and 14.3% (2/14) had permanent postoperative hypocalcemia. Eight patients had transient hypoparathyroidism, correlating with the rate of transient hypocalcemia. The most common reimplantation site was the sternocleidomastoid (11/14) and it was significantly associated with normalized calcium levels 6 months after auto-transplantation (p=0.033). Bilateral central neck dissection and surgical indication of cancer had a statistically significant association with transient hypocalcemia (p=0.03 and p=0.005, respectively). Our study provides valuable insights into the outcomes of PG auto-transplantation in pediatric patients, highlighting the potential for successful engraftment and factors associated with hypocalcemia.

摘要

甲状旁腺(PG)自体移植用于保留去血管化或意外切除的甲状旁腺的功能,然而,关于儿童甲状旁腺自体移植技术及结果的报道较少。在我们的研究中,我们旨在展示在一家三级单机构接受甲状腺切除术或甲状旁腺切除术的儿童中进行甲状旁腺自体移植的结果。一项回顾性研究确定了2000年1月至2022年12月期间接受甲状旁腺自体移植的14例(<18岁)患者。57.1%(8/14)的患者术后出现短暂性低钙血症,14.3%(2/14)的患者出现永久性术后低钙血症。8例患者出现短暂性甲状旁腺功能减退,与短暂性低钙血症的发生率相关。最常见的再植部位是胸锁乳突肌(11/14),且与自体移植后6个月血钙水平恢复正常显著相关(p=⁠0.033)。双侧中央区颈部淋巴结清扫和癌症手术指征与短暂性低钙血症有统计学显著相关性(分别为p=0.03和p=0.005)。我们的研究为儿科患者甲状旁腺自体移植的结果提供了有价值的见解,突出了成功植入的可能性以及与低钙血症相关的因素。

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