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Parathyroid Autotransplantation During Thyroidectomy
Documentation of Graft Function
Chung Yau Lo, MBBS(HK),MS(HK),FRCS(Edin);
Sidney C. Tam, MBBS(HK),FRCP,FRCPA
Arch Surg. 2001;136:1381-1385.
Hypothesis Biochemical function of normal parathyroid tissue grafted during thyroidectomy can be documented.
Design An intervention study in which devascularized or inadvertently removed parathyroid glands are reimplanted in forearm muscle pockets during thyroidectomy. Postoperative serum parathyroid hormone levels were evaluated by venous sampling from both forearms on postoperative days 1, 3, 14, 28, 56, and 84.
Setting Tertiary care teaching hospital.
Patients Seven patients undergoing thyroidectomy at risk for postoperative hypocalcemia.
Results A 1.5-fold gradient of parathyroid hormone measurements between grafted and nongrafted arms was demonstrated in all patients on postoperative day 28. A maximal parathyroid hormone gradient was reached on day 56, and biochemical function persisted in 6 patients on day 84.
Conclusions Biochemical function of parathyroid glands reimplanted during thyroidectomy can be demonstrated objectively. The application of parathyroid autotransplantation may preserve parathyroid function for inadvertently removed or devascularized parathyroid glands during thyroid surgery.
From the Departments of Surgery (Dr Lo) and Medicine (Dr Tam), University of Hong Kong Medical Center, Queen Mary Hospital.
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