Novel method to save the parathyroid gland during thyroidectomy: Subcapsular saline injection

Area of Science:

• Endocrine Surgery
• Surgical Innovation
• Thyroid Cancer Management

Background:

• Parathyroid gland preservation during thyroidectomy is a significant surgical challenge.
• Subcapsular saline injection (SCASI) was introduced in 2015 as a novel technique to aid parathyroid gland sparing.
• The efficacy of SCASI in preventing parathyroid gland dysfunction requires thorough evaluation.

Purpose of the Study:

• To assess the effectiveness of subcapsular saline injection (SCASI) in preserving parathyroid gland function after total thyroidectomy.
• To compare the incidence of transient and permanent hypoparathyroidism between patients who underwent SCASI and those who did not.

Main Methods:

• A retrospective cohort study included patients undergoing total thyroidectomy between 2013 and 2015.
• Patients were categorized into SCASI and non-SCASI groups, with 98 patients in each.
• Serum parathyroid hormone (PTH) levels were measured postoperatively to define and compare hypoparathyroidism rates.

Main Results:

• Demographics and surgical characteristics were comparable between the SCASI and non-SCASI groups.
• The SCASI group demonstrated significantly lower rates of transient hypoparathyroidism (19.4% vs 35.7%, P < .001).
• Permanent hypoparathyroidism was significantly reduced in the SCASI group (0% vs 4.1%, P = .043).

Conclusions:

• Subcapsular saline injection (SCASI) is an effective method for preserving parathyroid gland function during thyroidectomy.
• The SCASI technique leads to a significant decrease in both transient and permanent hypoparathyroidism.
• This study supports the routine adoption of SCASI in thyroidectomy procedures to improve patient outcomes.