Clinical significance of retrograde inferior parathyroid protection technique based on thymus preservation in thyroid surgery
Abstract Background The importance of parathyroid gland preservation in thyroid surgery has been well recognized; however, the rapid identification of the parathyroid gland, particularly the inferior parathyroid gland (IPG), remains challenging. This study aimed to evaluate the effectiveness of retr...
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BMC
2025-01-01
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| Series: | BMC Endocrine Disorders |
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| Online Access: | https://doi.org/10.1186/s12902-025-01838-y |
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| author | Shouyi Yan Yuhan Chen Wenxin Zhao Liyong Zhang Shaojun Cai |
| author_facet | Shouyi Yan Yuhan Chen Wenxin Zhao Liyong Zhang Shaojun Cai |
| author_sort | Shouyi Yan |
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| description | Abstract Background The importance of parathyroid gland preservation in thyroid surgery has been well recognized; however, the rapid identification of the parathyroid gland, particularly the inferior parathyroid gland (IPG), remains challenging. This study aimed to evaluate the effectiveness of retrograde inferior parathyroid protection technique (RIPPT) based on thymus preservation. Methods A total of 236 patients were enrolled in this study between August 2019 and December 2020. RIPPT was employed to identify and protect the inferior parathyroid gland (IPG), and its identification rate and the anatomical variations were analyzed. The parathyroid hormone (PTH) and serum calcium levels were compared between patients who underwent IPG orthotopic retention and those who received IPG auto-transplantation, stratified by the anatomical type of the IPG. Results In total, the IPG identification rate was 97.88% (231/236), and the auto-transplantation rate was 74.46% (172/231). The anatomical relationship between IPG and thymus was observed in 77.97% of patients (184/236). Additionally, PTH levels were higher in patients with IPG orthotopic retention compared to those with IPG auto-transplantation both on postoperative day 1 (POD1) and at 6 months. PTH levels were also higher in patients with superior parathyroid gland (SPG) and IPG orthotopic retention compared to those who underwent both auto-transplantation procedures. Conclusion Retrograde inferior parathyroid protection technique (RIPPT) underscores the importance of protecting inferior parathyroid gland (IPG) in thyroid surgery and has been demonstrated to be effective in the rapid identification and functional preservation of IPG, based on short-term outcomes. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-fd8dcdeceb034119aeae9dc286c4b932 |
| institution | Kabale University |
| issn | 1472-6823 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Endocrine Disorders |
| spelling | doaj-art-fd8dcdeceb034119aeae9dc286c4b9322025-01-26T12:37:33ZengBMCBMC Endocrine Disorders1472-68232025-01-0125111110.1186/s12902-025-01838-yClinical significance of retrograde inferior parathyroid protection technique based on thymus preservation in thyroid surgeryShouyi Yan0Yuhan Chen1Wenxin Zhao2Liyong Zhang3Shaojun Cai4The Department of Thyroid Surgery, Fujian Medical University Union HospitalThe Department of Thyroid Surgery, Fujian Medical University Union HospitalThe Department of Thyroid Surgery, Fujian Medical University Union HospitalThe Department of Thyroid Surgery, Fujian Medical University Union HospitalThe Department of Thyroid Surgery, Fujian Medical University Union HospitalAbstract Background The importance of parathyroid gland preservation in thyroid surgery has been well recognized; however, the rapid identification of the parathyroid gland, particularly the inferior parathyroid gland (IPG), remains challenging. This study aimed to evaluate the effectiveness of retrograde inferior parathyroid protection technique (RIPPT) based on thymus preservation. Methods A total of 236 patients were enrolled in this study between August 2019 and December 2020. RIPPT was employed to identify and protect the inferior parathyroid gland (IPG), and its identification rate and the anatomical variations were analyzed. The parathyroid hormone (PTH) and serum calcium levels were compared between patients who underwent IPG orthotopic retention and those who received IPG auto-transplantation, stratified by the anatomical type of the IPG. Results In total, the IPG identification rate was 97.88% (231/236), and the auto-transplantation rate was 74.46% (172/231). The anatomical relationship between IPG and thymus was observed in 77.97% of patients (184/236). Additionally, PTH levels were higher in patients with IPG orthotopic retention compared to those with IPG auto-transplantation both on postoperative day 1 (POD1) and at 6 months. PTH levels were also higher in patients with superior parathyroid gland (SPG) and IPG orthotopic retention compared to those who underwent both auto-transplantation procedures. Conclusion Retrograde inferior parathyroid protection technique (RIPPT) underscores the importance of protecting inferior parathyroid gland (IPG) in thyroid surgery and has been demonstrated to be effective in the rapid identification and functional preservation of IPG, based on short-term outcomes. Clinical trial number Not applicable.https://doi.org/10.1186/s12902-025-01838-yInferior parathyroid glandPapillary thyroid cancerThymus-related inferior parathyroid glandThyroid surgeryRetrograde inferior parathyroid protection techniqueThymus preservation |
| spellingShingle | Shouyi Yan Yuhan Chen Wenxin Zhao Liyong Zhang Shaojun Cai Clinical significance of retrograde inferior parathyroid protection technique based on thymus preservation in thyroid surgery BMC Endocrine Disorders Inferior parathyroid gland Papillary thyroid cancer Thymus-related inferior parathyroid gland Thyroid surgery Retrograde inferior parathyroid protection technique Thymus preservation |
| title | Clinical significance of retrograde inferior parathyroid protection technique based on thymus preservation in thyroid surgery |
| title_full | Clinical significance of retrograde inferior parathyroid protection technique based on thymus preservation in thyroid surgery |
| title_fullStr | Clinical significance of retrograde inferior parathyroid protection technique based on thymus preservation in thyroid surgery |
| title_full_unstemmed | Clinical significance of retrograde inferior parathyroid protection technique based on thymus preservation in thyroid surgery |
| title_short | Clinical significance of retrograde inferior parathyroid protection technique based on thymus preservation in thyroid surgery |
| title_sort | clinical significance of retrograde inferior parathyroid protection technique based on thymus preservation in thyroid surgery |
| topic | Inferior parathyroid gland Papillary thyroid cancer Thymus-related inferior parathyroid gland Thyroid surgery Retrograde inferior parathyroid protection technique Thymus preservation |
| url | https://doi.org/10.1186/s12902-025-01838-y |
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