Fine-Needle Pricking Test of the Parathyroid Gland during Thyroid Surgery in Predicting Parathyroid Function

Background. Permanent hypoparathyroidism is a serious complication following total thyroidectomy plus central neck dissection (CND). How to evaluate the vascularization of the parathyroid gland in real time is a major concern of thyroid surgeons. This study aimed to evaluate the fine-needle pricking...

Full description

Saved in:
Bibliographic Details
Main Authors: Ying-Jun Wu, Jian-Biao Wang, Fei-Bo Li, Lei Jin, Liang Zhou, Lei Xie
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:International Journal of Endocrinology
Online Access:http://dx.doi.org/10.1155/2022/8747680
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832551041194786816
author Ying-Jun Wu
Jian-Biao Wang
Fei-Bo Li
Lei Jin
Liang Zhou
Lei Xie
author_facet Ying-Jun Wu
Jian-Biao Wang
Fei-Bo Li
Lei Jin
Liang Zhou
Lei Xie
author_sort Ying-Jun Wu
collection DOAJ
description Background. Permanent hypoparathyroidism is a serious complication following total thyroidectomy plus central neck dissection (CND). How to evaluate the vascularization of the parathyroid gland in real time is a major concern of thyroid surgeons. This study aimed to evaluate the fine-needle pricking (FNP) test in predicting parathyroid gland function. Methods. The FNP test was performed in patients undergoing total thyroidectomy plus CND between January 1, 2014, and December 31, 2019, to visualize the vascularization of the parathyroid glands. Patients were classified according to the number of parathyroid glands preserved in situ with excellent vascularity (PGPIEV) demonstrated by FNP: group 0 (without PGPIEV), group 1 (with one PGPIEV), group 2 (with two PGPIEV), group 3 (with three PGPIEV), and group 4 (with four PGPIEV). Results. A total of 608 patients with four parathyroid glands underwent FNP testing during thyroidectomy. At least one PGPIEV was demonstrated by FNP testing in 581 patients who had intact parathyroid hormone (iPTH) levels in the normal range after the operation. The prevalence of hypocalcemia decreased from 77.8% in group 0 to 9.8% in group 4 (P<0.001), and the incidence of hypoparathyroidism decreased from 44.4% in group 0 to 0% in groups 1–4 (P<0.001). iPTH concentrations on postoperative day 1 were positively correlated with PGPIEV groups (increased from 14.58 ng/l in group 0 to 45.22 ng/l in group 4, P<0.001). Conclusions. The FNP test is a safe and reliable method to predict parathyroid function. One PGPIEV demonstrated by the FNP test rules out the possibility of patients developing hypoparathyroidism.
format Article
id doaj-art-4213d3d6322b44b39fe960b51d4ea341
institution Kabale University
issn 1687-8345
language English
publishDate 2022-01-01
publisher Wiley
record_format Article
series International Journal of Endocrinology
spelling doaj-art-4213d3d6322b44b39fe960b51d4ea3412025-02-03T06:05:01ZengWileyInternational Journal of Endocrinology1687-83452022-01-01202210.1155/2022/8747680Fine-Needle Pricking Test of the Parathyroid Gland during Thyroid Surgery in Predicting Parathyroid FunctionYing-Jun Wu0Jian-Biao Wang1Fei-Bo Li2Lei Jin3Liang Zhou4Lei Xie5Department of Operation Room NursingDepartment of Head and Neck SurgerySecond Department of General SurgeryDepartment of Head and Neck SurgeryDepartment of Head and Neck SurgeryDepartment of Head and Neck SurgeryBackground. Permanent hypoparathyroidism is a serious complication following total thyroidectomy plus central neck dissection (CND). How to evaluate the vascularization of the parathyroid gland in real time is a major concern of thyroid surgeons. This study aimed to evaluate the fine-needle pricking (FNP) test in predicting parathyroid gland function. Methods. The FNP test was performed in patients undergoing total thyroidectomy plus CND between January 1, 2014, and December 31, 2019, to visualize the vascularization of the parathyroid glands. Patients were classified according to the number of parathyroid glands preserved in situ with excellent vascularity (PGPIEV) demonstrated by FNP: group 0 (without PGPIEV), group 1 (with one PGPIEV), group 2 (with two PGPIEV), group 3 (with three PGPIEV), and group 4 (with four PGPIEV). Results. A total of 608 patients with four parathyroid glands underwent FNP testing during thyroidectomy. At least one PGPIEV was demonstrated by FNP testing in 581 patients who had intact parathyroid hormone (iPTH) levels in the normal range after the operation. The prevalence of hypocalcemia decreased from 77.8% in group 0 to 9.8% in group 4 (P<0.001), and the incidence of hypoparathyroidism decreased from 44.4% in group 0 to 0% in groups 1–4 (P<0.001). iPTH concentrations on postoperative day 1 were positively correlated with PGPIEV groups (increased from 14.58 ng/l in group 0 to 45.22 ng/l in group 4, P<0.001). Conclusions. The FNP test is a safe and reliable method to predict parathyroid function. One PGPIEV demonstrated by the FNP test rules out the possibility of patients developing hypoparathyroidism.http://dx.doi.org/10.1155/2022/8747680
spellingShingle Ying-Jun Wu
Jian-Biao Wang
Fei-Bo Li
Lei Jin
Liang Zhou
Lei Xie
Fine-Needle Pricking Test of the Parathyroid Gland during Thyroid Surgery in Predicting Parathyroid Function
International Journal of Endocrinology
title Fine-Needle Pricking Test of the Parathyroid Gland during Thyroid Surgery in Predicting Parathyroid Function
title_full Fine-Needle Pricking Test of the Parathyroid Gland during Thyroid Surgery in Predicting Parathyroid Function
title_fullStr Fine-Needle Pricking Test of the Parathyroid Gland during Thyroid Surgery in Predicting Parathyroid Function
title_full_unstemmed Fine-Needle Pricking Test of the Parathyroid Gland during Thyroid Surgery in Predicting Parathyroid Function
title_short Fine-Needle Pricking Test of the Parathyroid Gland during Thyroid Surgery in Predicting Parathyroid Function
title_sort fine needle pricking test of the parathyroid gland during thyroid surgery in predicting parathyroid function
url http://dx.doi.org/10.1155/2022/8747680
work_keys_str_mv AT yingjunwu fineneedleprickingtestoftheparathyroidglandduringthyroidsurgeryinpredictingparathyroidfunction
AT jianbiaowang fineneedleprickingtestoftheparathyroidglandduringthyroidsurgeryinpredictingparathyroidfunction
AT feiboli fineneedleprickingtestoftheparathyroidglandduringthyroidsurgeryinpredictingparathyroidfunction
AT leijin fineneedleprickingtestoftheparathyroidglandduringthyroidsurgeryinpredictingparathyroidfunction
AT liangzhou fineneedleprickingtestoftheparathyroidglandduringthyroidsurgeryinpredictingparathyroidfunction
AT leixie fineneedleprickingtestoftheparathyroidglandduringthyroidsurgeryinpredictingparathyroidfunction