SURGICAL PREVENTION AND TREATMENT OF POSTOPERATIVE HYPOPARATHYROIDISM IN PATIENTS OPERATED ON THYROID GLAND

Area of Science:

• Endocrinology
• Surgical Oncology
• Pharmacology

Background:

• Postoperative hypoparathyroidism (PHPT) is a common complication following thyroid gland surgeries.
• Current management strategies for PHPT lack a standardized approach for intraoperative parathyroid gland (PTG) assessment and postoperative care.
• Effective prevention and treatment protocols are crucial to minimize long-term morbidity associated with PHPT.

Purpose of the Study:

• To develop and evaluate a novel algorithm for the prevention and treatment of PHPT.
• The algorithm integrates intraoperative assessment of PTG viability with postoperative antihypoxant-antioxidant therapy.
• To reduce the incidence and severity of PHPT in patients undergoing thyroid surgery.

Main Methods:

• A comprehensive algorithm was developed, involving intraoperative visual assessment of PTG viability (0-3 points).
• Glands with scores of 0-2 were preserved in situ; those scoring 3 underwent autotransplantation.
• Postoperative antihypoxant-antioxidant therapy was administered using Cytoflavin (10 ml in 200 ml 0.9% NaCl IV daily for 7 days).
• A comparative study was conducted with 60 patients, divided into two groups (30 each): Group I (standard care) and Group II (proposed algorithm).

Main Results:

• The proposed algorithm, incorporating intraoperative PTG viability assessment and postoperative antihypoxant-antioxidant therapy, demonstrated a significant reduction in the frequency of permanent PHPT.
• Patients treated with the new algorithm showed improved outcomes compared to the control group.
• The study provides evidence supporting the efficacy of the developed algorithm in managing PHPT.

Conclusions:

• The developed algorithm for intraoperative PTG viability assessment and postoperative antihypoxant-antioxidant therapy is effective in preventing and treating PHPT.
• This approach offers a promising strategy to improve patient outcomes after thyroid surgery.
• The findings justify the broader application of this algorithm in surgical practice.