This study aimed to examine the effect of selective inferior parathyroid gland autotransplantation on central lymph node dissection(CLND) and incidence of postoperative hypoparathyroidism in patients undergoing endoscopic radical resection of thyroid carcinoma.

The data of 310 patients undergoing endoscopic radical resection of thyroid carcinoma will be retrospectively analyzed. The patients will be divided into the experimental group and the control group according to whether they combined with parathyroid autotransplantation. Statistics of the incidence rate of postoperative hypoparathyroidism, the concentration of PTH and Calcium in the systemic circulation at different time points in the two groups, the concentration of PTH in the cubital fossa vein in the transplantation region in the experimental group, and the number of central lymph nodes and positive lymph nodes dissection will be carried out.

The incidence rate of temporary and permanent hypoparathyroidism in the experimental group was 33.75% and 0.625%, respectively, and in the control group was 22% and 5%, respectively; its difference was statistically significant (X^{2 =} 10.255, P=0.006). Parathyroid autotransplantation increased incidence of transient hypoparathyroidism (OR, 1.806; Cl, 1.088-2.998; P=0.022), and lower incidence of permanent hypoparathyroidism (OR, 0.112; Cl, 0.014-0.904; P=0.040). The diameters of thyroid cancer nodules was not associated with the occurrence of transient hypoparathyroidism (OR, 0.769; Cl, 0.467-1.265; P=0.301) or permanent hypoparathyroidism (OR, 1.434; Cl, 0.316-6.515; P=0.641). Comparison of systemic circulation PTH, between the two groups showed that the PTH of patients in the experimental group was higher than that in the control group from 1 week to 12 months after the operation, and the difference was statistically significant (P<0.05). In the experimental group, from 1 week to 12 months after surgery, PTH concentrations was significantly higher in the cubital fossa of the transplantation side than in the contralateral side, and the differences were statistically significant (P<0.05). The mean number of central lymph node dissected per patient was significantly higher in the experimental group (7.94 ± 3.03 vs. 6.99 ± 2.86; P <0.05); The mean number of positive nodes per patient was significantly higher in the experimental group (3.16 ± 1.86 vs. 2.53 ± 1.59; P <0.05).

In endoscopic radical resection of thyroid carcinoma, parathyroid autotransplantation is more beneficial to postoperative parathyroid glands function recovery, effectively preventing postoperative permanent hypoparathyroidism and realizing more thorough CLND.

本研究旨在探讨选择性下甲状旁腺自体移植对内镜下甲状腺癌根治术患者中央淋巴结清扫术（CLND）及术后甲状旁腺功能低下发生率的影响。

回顾性分析310例甲状腺癌内镜根治术患者的资料。根据是否联合甲状旁腺自体移植将患者分为实验组和对照组。统计两组术后甲状旁腺功能减退症的发生率、不同时间点体循环中PTH和钙的浓度、实验组移植区肘窝静脉PTH浓度、移植次数将进行中央淋巴结和阳性淋巴结清扫。

实验组暂时性和永久性甲状旁腺功能减退的发生率分别为33.75%和0.625%，对照组分别为22%和5%；其差异具有统计学意义（X ^{2 =}10.255，P=0.006）。甲状旁腺自体移植增加了短暂性甲状旁腺功能减退的发生率（OR，1.806；Cl，1.088-2.998；P=0.022），降低了永久性甲状旁腺功能减退的发生率（OR，0.112；Cl，0.014-0.904；P=0.040）。甲状腺癌结节的直径与短暂性甲状旁腺功能减退（OR，0.769；Cl，0.467-1.265；P=0.301）或永久性甲状旁腺功能减退（OR，1.434；Cl，0.316-6.515；P=0.641）的发生无关。两组体循环PTH比较显示，实验组患者术后1周至12个月PTH均高于对照组，差异有统计学意义（P<0.05）。实验组术后1周至12个月，移植侧肘窝PTH浓度明显高于对侧，差异有统计学意义（P<0.05）。实验组每位患者平均切除的中央淋巴结数量显着增加（7.94 ± 3.03 vs. 6.99 ± 2.86；P <0.05）；实验组每位患者的平均阳性淋巴结数显着增加（3.16 ± 1.86 vs. 2.53 ± 1.59；P <0.05）。16 ± 1.86 与 2.53 ± 1.59；P <0.05）。16 ± 1.86 与 2.53 ± 1.59；P <0.05）。

在内镜下甲状腺癌根治术中，自体甲状旁腺移植更有利于术后甲状旁腺功能恢复，有效预防术后永久性甲状旁腺功能减退，实现更彻底的CLND。