Novel method to save the parathyroid gland during thyroidectomy: Subcapsular saline injection.

Abstract

Saving the parathyroid gland during thyroidectomy remains challenging. Subcapsular saline injection (SCASI) was developed in February 2015. Its ability to spare the parathyroid gland was assessed. All consecutive patients who underwent total thyroidectomy with or without neck lymph node dissection in 2013-2015 were included in this retrospective cohort study. Patients were divided into the SCASI and non-SCASI groups. Serum parathyroid hormone (PTH) levels were measured on day 1 and 6 months after surgery. Transient and permanent hypoparathyroidism were defined as day 1 and 6 month PTH < 10.0 and <15.0 pg/mL, respectively. The groups (both had 98 patients each) did not differ in demographics, tumor size, operation extent, pathology, thyroiditis rate, and incidental parathyroid gland excision rate. Compared with non-SCASI patients, patients who underwent the SCASI method exhibited transient hypoparathyroidism (35.7% vs 19.4%, P < .001) and permanent hypoparathyroidism (4.1% vs 0%, P = .043) significantly less frequently. The procedure of SCASI effectively spared the parathyroid gland during thyroidectomy.