Shun-Yu Chi, Fong-Fu Chou, Yi-Chia Chan, Shun-Cheng Huang and Jin-Bor Chen
Kaohsiung Chang Gung Memorial Hospital, Taiwan
Posters & Accepted Abstracts: Surgery Curr Res
Background: To find out if it is necessary to do bilateral cervical thymectomy (BCT) during total parathyroidectomy plus autotransplantation (TPXT+AT) for symptomatic secondary hyperparathyroidism (SSHP). Methods: 147 patients (group A) with SSHP were operated on with TPXT+AT and BCT; 153 patients (group B) were with TPXT+AT and selective thymectomy at the side of a missing gland. The serum intact parathyroid hormone level less than 60 pg/ml in one week was defined as successful surgery. Patient�??s characteristics, operative findings and operative results were compared between the two groups and all removed thymuses were examined, localization studies were applied for 20 of 54 patients with the primary surgical failure. Results: There was no significant difference between the two groups regarding patient�??s characteristics, operative findings, the primary successful rates and successful rates after reoperations. In group A patients, the successful rates after primary surgery between, patients who had 4 or more glands and those had 3 glands being removed were significant (p=0.003) and so were group B patients (p=0.001). After localization procedures, 12 parathyroid glands were found in the neck, 7 in mediastinum, one failed to be localized and none in thymic tongue. 13 parathyroid glands were found and removed in reoperations, 9 were in the neck and 4 in mediastinum (via thoracoscope). Histological examinations of 327 thymuses showed parathyroid glands in 14 among which 13 could be found during surgery and one had microscopic parathyroid tissue. Conclusion: If four or more glands are found, thymectomy is optional and not necessary.
Shun-Yu Chi graduated from the School of Medicine, Kaohsiung Medical University during the academic year 1990-1997. During 1999-2004, he worked as a Resident in Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Taiwan. Then, during the years 2004-2008, he was an Attending Physician in Department of Emergency and Traumatic Surgery, Kaohsiung Chang Gung Memorial Hospital, Taiwan. In 2006 and 2007, he was a Fellow in Department of Surgery, Lukas Hospital, Germany. During 2008-2013, he was an Attending Physician in Department of General Surgery, Kaohsiung Chang Gung Memorial Hospital, Taiwan and in 2013, he was an Assistant Professor in Department of General Surgery, Kaohsiung Chang Gung Memorial Hospital, Taiwan. He is also a member of Taiwan Surgical Association, Taiwan Surgical Society of Gastroenterology, and Taiwan Association of Endocrine Surgeon.
