Significance of 'butterfly-shaped' free prophylactic resection of the inferior thyroid artery on the intraoperative dissection of the parathyroid glands

doi:10.13418/j.issn.1001-165x.2025.5.15

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Chinese Journal of Clinical Anatomy ›› 2025, Vol. 43 ›› Issue (5) : 595-598. DOI: 10.13418/j.issn.1001-165x.2025.5.15

Significance of 'butterfly-shaped' free prophylactic resection of the inferior thyroid artery on the intraoperative dissection of the parathyroid glands

Li Yongtian¹, Wang Rujuan¹, Cheng Danqing¹, Wang Wenping¹, Zhao Feng¹*, Zhang Yi²

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Abstract

Objective To investigate the significance of 'butterfly-shaped' free dissection of the thyroid lobe and prophylactic resection of the inferior thyroid artery during the surgical treatment of secondary hyperparathyroidism. Methods From May 2020 to February 2024, 67 patients diagnosed with secondary hyperparathyroidism and underwent surgical treatment in our hospital were reviewed. All patients underwent total parathyroidectomy combined with autotransplantation, including 31 patients with resection of the inferior thyroid artery (study group) and 36 patients with preservation of the inferior thyroid artery (control group). The perioperative indicators and postoperative long-term conditions were compared to evaluate the surgical efficacy. Results There was no significant difference in thyroid function and imaging results between the study group before and after operation. There was no significant difference in the operation time, intraoperative blood loss, postoperative 1 d drainage volume and postoperative hospital stay between the two groups. There was no significant difference in parathyroid hormone results between the two groups at 10 min, 1 h, 1 d, 1 week and 1 month after operation. The parathyroid hormone in the study group was lower at 3 months and 6 months after operation (P<0.05). Conclusions The 'butterfly-shaped' free thyroid lobe is beneficial to expose the parathyroid gland in the conventional position, which is convenient to combine the preoperative imaging to locate the hyperplastic parathyroid gland. Whether to remove the inferior thyroid artery has no significant difference in the difficulty of surgery and postoperative recovery and will not affect the thyroid function of patients. Preventive resection of the inferior thyroid artery can reduce the possibility of long-term recurrence, and is more suitable for patients with ectopic parathyroid glands and difficult to identify the scope of dissection during the operation.

Key words

Secondary hyperparathyroidism; / Parathyroid gland; / Inferior thyroid artery; / Parathyroid hormone

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Li Yongtian, Wang Rujuan, Cheng Danqing, Wang Wenping, Zhao Feng, Zhang Yi. Significance of 'butterfly-shaped' free prophylactic resection of the inferior thyroid artery on the intraoperative dissection of the parathyroid glands[J]. Chinese Journal of Clinical Anatomy. 2025, 43(5): 595-598 https://doi.org/10.13418/j.issn.1001-165x.2025.5.15

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