The use of Chromothyrolymphography for parathyroid gland protection during thyroid surgery
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Background.Postoperative hypoparathyroidism (PHPT) has appeared due to damage or inadvertent removal of parathyroid glands (PTG) during thyroid surgery. Indirect chromothyrolymphography (ICTLG) utilizes injection of the dye into the Thyroid in order to visualize intraorganic lymphatic network, and extrathyrioidlymphatic vessels and regional lymph nodes, as well. Weinjectedinto thyroid glandeither 2–3 ml of 1% Methylene blue in water or alcohol, or 1% Brilliant green in alcohol.
Purpose. of the study to decrease the rate of clinical and asymptomatic PHPT by improvement of thyroidectomy (TE) technique and using of calcium mineral complex in all thyroid patients since the first postoperative day.
Method. Were identified sources of all PTG blood supplying during 170 Thyroid Surgery. We injectedinto thyroid glandeither 2–3 ml of 1% Methylene blue in water or alcohol, or 1% Brilliant green in alcoholand protect PTG by good visualization. PTG don’t change the color. Postoperatively were investigated level dynamics of calcium, parathyroid hormone (PTH), with and without of patient’s supplementation by CMC after thyroidectomy or subtotal TE in Diffuse Toxic Goiter (DTG), Papillary Thyroid Cancer (PTC) and Nodular Euthyroid Goiter (NEG) cases.
Results. In group of ICTLGPHPT registered rather then without it.
Conclusion. ICTLG is the good method for PTG protection.
Two Approaches to Level 5 Neck Dissection
- Jeff Blumberg