Med Bull Sisli Etfal Hosp. 2009; 43(1): 33-37

Parathyroid autotransplantation during thyroidectomy

Mehmet Uludað¹, Gürkan Yetkin¹, Bülent Çitgez¹, Adnan Iþgör², Abut Kebudi^3
1Second Department of General Surgery, Þiþli Etfal Training and Research Hospital, Istanbul, Turkey
²Institute of Medical Sciences, Haliç University, Istanbul
³Department of General Surgery, Maltepe University, Faculty of Medicine, Istanbul, Turkey

Objective: Permanent hypoparathyroidism is one of the most distressing complications following throidectomy. Apart from preservation of
parathyroid glands in situ by meticulous dissection, parathyroid autotransplantation has been performed increasingly to avoid permanent
hypoparathyroidism. The aim of this study was to evaluate the surgical outcomes in patients undergoing thyroidectomy with parathyroid
autotransplantation.
Study design: From 2002 to 2005, selective parathyroid autotransplantation was performed for devascularized or inadvertently
removed glands in 18 (5.08%) of 354 patients undergoing thyroidectomy.
Results: Total postoperative hypocalcemia occured in 5 (27.7%) of the parathyroid autotransplantation patients, and four patient had transient hypoparathyroidism, whereas 1 patient had permanent hypoparathyroidism. None of the 336 patients who did not undergo parathyroid autotransplantation had permanent hypoparathyroidism.
Conclusion: Selective autotransplantation of the parathyroid glands should be performed whenever the parathyroid is devascularized or damaged. Selective approach to parathyroid outotransplantation is an effective strategy for minimizing the rate of the permanent hypoparathyroidism.

Keywords: Thyroidectomy, parathyroid outotransplantation, hypocalcemia, hypoparathyroidism

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Tiroidektomide paratiroid ototransplantasyonu

Mehmet Uludað¹, Gürkan Yetkin¹, Bülent Çitgez¹, Adnan Iþgör², Abut Kebudi^3
1Þiþli Etfal Eðitim ve Araþtýrma Hastanesi, 2. Genel Cerrahi Kliniði, Ýstanbul
²Haliç Üniversitesi, Saðýlýk Bilimleri Enstitüsü, Ýstanbul
³Maltepe Üniversitesi, Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Ýstanbul

Amaç: Kalýcý hipoparatiroidism tiroidektomide korkulan komplikasyonlardan biridir. Kalýcý hipoparatiroidismden kaçýnmak için dikkatli diseksiyonla paratiroid bezlerinin korunmasý dýþýnda paratiroid ototransplantasyonu artarak uygulanmaktadýr. Bu çalýþmada tiroidektomi sýrasýnda paratiroid ototransplantasyonu uygulanan hastalarýn sonuçlarýný deðerlendirmeyi amaçladýk.
Gereç ve Yöntem: 2002-2005 arasýnda tiroidektomi uygulanan 354 hastadan 18’inde damarlanmasý bozulan veya istemeden çýkarýlan paratiroid bezleri seçilmiþ olarak ototransplante edildi.
Bulgular: 18 hastanýn 5’inde (%27.7) postoperatif hipokalsemi geliþti. Bunlarýn 4’ü geçici olup, 1 hastada kalýcý hipoparatiroidism geliþti. Paratiroid ototransplantasyonu uygulanmayan 336 hastanýn hiçbirinde kalýcý hipoparatiroidism geliþmedi.
Sonuçlar: Tiroidektomi sýrasýnda damarlanmasý bozulan veya hasarlanan paratiroid bezleri seçici olarak ototransplante edilmelidir. Paratiroid ototransplantasyonunda seçici yaklaþým kalýcý hipoparatiroidism oranýný en aza indirmek için etkili bir yöntemdir.

Anahtar Kelimeler: Tiroidektomi, paratiroid ototransplantasyonu, hipokalsemi, hipoparatiroidism

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