Thyroid Cancer
Conditions
Brief summary
The incidence of temporary hypoparathyroidism after thyroid surgery is 14%-60%, and the incidence of permanent hypoparathyroidism is 4%-11%. The protection of parathyroids has always been the focus and difficulty of thyroid surgery. The anatomical position of the superior parathyroids is relatively fixed, and can be preserved in situ easily; while the anatomical position of inferior parathyroids varies greatly between patients. It is always difficult to look for, identify, and protect them. Concepts such as thyro-thymic ligament and thymus-vascular-inferior parathyroid plane were raised to help identify the inferior parathyroids. We found that this surgical strategy can protect inferior parathyroids in situ effectively in our retrospective studies. Thus, we are going to carry out a prospective study to compare the new method and the traditional method of thyroidectomy, to see if more inferior parathyroids can be protected in situ through the new surgical strategy.
Interventions
PROCEDUREResection based on thymus-vascular-inferior parathyroid complex
Before clearing the central lymph nodes, looking for the thyro-thymic ligament first, looking for the inferior parathyroid along the thyro-thymic ligament. Dissect and leave the thymus-vascular-inferior parathyroid complex laterally; the inner side of this layer is the tissue of the central area. Then remove the central lymph nodes. Check for parathyroids in the removed specimen, transplant the parathyroids which are removed by accident.
Sponsors
Second Affiliated Hospital, School of Medicine, Zhejiang University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* initial thyroid surgery; thyroidectomy with/without central lymph node dissection
Exclusion criteria
* coexisting parathyroid disease; need lateral neck dissection; history of radio-iodine ablation treatment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Primary outcome | Postoperative day 1 | the incidence of hypothyroidism |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Secondary outcome | Postoperative day 1 | the incidence of parathyroid hormone reduced greater than 50% than parathyroid hormone level before surgery |
Other
| Measure | Time frame | Description |
|---|---|---|
| Other outcome | 3 weeks after surgery, then every 3 month during the first year after surgery until 12 months after surgery | time to recover from hypoparathyroidism |
Countries
China
Contacts
Primary ContactQunzi Zhao, M.D.
Outcome results
None listed