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[Evaluation on our procedure for autotransplantation of parathyroid glands by the intact-PTH]
1Second Department of Surgery, Nagoya University, School of Medicine, Japan.
In thyroid cancer surgery since 1978 we have made parathyroidal autotransplantation which has been to resect the entire parathyroid, cut fine to mud and autotransplant into greater pectoral muscle. To evaluate our procedure and consider the mechanism of hypocalcemia and tetanus following surgery, we examined the intact-PTH recovered to about 80% of its preoperative value on 14-postoperative-days and thereafter remained almost constant. It remained below the sensitivity of measurement from immediately to 3-postoperative-days, and with our procedure, parathyroid was considered to be totally resected. Comparison between 2 (6 cases) and more autotransplanted glands (11 cases) revealed that the former showed slightly later functional recovery, but recovered to the almost some extent as the other 21-postoperative-days. Comparison between the group requiring calcium supplement therapy (12 cases) and the otherwise (5 cases) revealed almost the same course of recovery. Thus, our procedure seems to enable us to make satisfactory functional preservation and expect functional recovery by 2-gland autotransplantation at least. The supplement therapy was considered not to be detrimental to the take of autotransplanted glands and functional recovery, and no correlation was noted between the onset of tetanus and intact-PTH.
In thyroid cancer surgery since 1978 we have made parathyroidal autotransplantation which has been to resect the entire parathyroid, cut fine to mud and autotransplant into greater pectoral muscle. To evaluate our procedure and consider the mechanism of hypocalcemia and tetanus following surgery, we examined the intact-PTH recovered to about 80% of its preoperative value on 14-postoperative-days and thereafter remained almost constant. It remained below the sensitivity of measurement from immediately to 3-postoperative-days, and with our procedure, parathyroid was considered to be totally resected. Comparison between 2 (6 cases) and more autotransplanted glands (11 cases) revealed that the former showed slightly later functional recovery, but recovered to the almost some extent as the other 21-postoperative-days. Comparison between the group requiring calcium supplement therapy (12 cases) and the otherwise (5 cases) revealed almost the same course of recovery. Thus, our procedure seems to enable us to make satisfactory functional preservation and expect functional recovery by 2-gland autotransplantation at least. The supplement therapy was considered not to be detrimental to the take of autotransplanted glands and functional recovery, and no correlation was noted between the onset of tetanus and intact-PTH.