The following is a summary of “Impact of Intraoperative Nanocarbon Staining and parathyroid autotransplantation on parathyroid injury and recovery in adult thyroidectomy: a retrospective cohort study,” published in the November 2024 issue of Surgery by Chen et al.
Thyroid surgery carries risks of parathyroid gland damage, which can lead to hypocalcemia and long-term hypoparathyroidism. Intraoperative Nanocarbon Staining (INS) is a technique designed to improve the preservation of parathyroid glands during surgery.
Researchers conducted a retrospective study to assess the impact of INS and parathyroid autotransplantation on reducing parathyroid injury and improving recovery after thyroidectomy.
They reviewed data from patients aged 18 and older who underwent thyroid surgery (January 2017 to December 2022). Postoperative parathyroid injury, recovery rates, and the incidence of permanent hypoparathyroidism were compared between 2 groups, 101 in the intervention group and 97 in the control group. Statistical analysis included chi-square tests, t-tests, and logistic regression.
The results showed that patients in the intervention group had shorter duration of intravenous calcium supplementation (median 2 vs. 3 days, P<0.001), higher calcium nadir levels (median 8.36 vs. 7.85 mg/dL, P<0.001), and lower rates of postoperative parathyroid injury (15.84% vs. 20.62%, P=0.045) and permanent hypoparathyroidism (4.95% vs. 15.46%, P=0.003). Multivariate analysis revealed that factors such as blood intact parathyroid hormone (iPTH) monitoring level (OR 1.053, 95% CI 1.009–1.099, P=0.018) and surgery type (Near Total Thyroidectomy) (OR 0.447, 95% CI 0.202–0.990, P=0.047) were positively associated with surgical success.
They concluded that the use of INS and parathyroid autotransplantation during thyroidectomy improves parathyroid function and reduces the incidence of permanent hypoparathyroidism.
Source: bmcsurg.biomedcentral.com/articles/10.1186/s12893-024-02679-7
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