유두갑상선암의 고식적 갑상선전절제술과 내시경하 갑상선전절제술 후 부갑상선 보존율 비교분석

• 영문명: Comparison of Parathyroid Gland Preservation Rates between Open and Endoscopic Total Thyroidectomy for Papillary Thyroid Carcinomas
• 발행기관: 대한내분비외과학회
• 저자명: 김정빈 박인석 조현진 곽금희 양근호 배병노 김기환 한세환 Jungbin Kim M.D. Inseok Park M.D. Hyunjin Cho M.D. Geumhee Gwak M.D. Keunho Yang M.D. Byungnoe Bae M.D. Kiwhan Kim M.D. and Sehwan Han M.D.
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』12권2호, 98~101쪽, 전체 4쪽
• 주제분류: 의약학 > 면역학
• 파일형태: PDF
• 발행일자: 2012.06.30

영문 초록

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. (Korean J Endocrine Surg 2012;12: 0-101)

키워드

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