Abstract:
Permanent hypoparathyroidism is a postoperative complication of thyroid and parathyroid surgery and can be cured by cryopreserved parathyroid autotransplantation (CPAT). However, due to the lack of unified and standardized guidelines, the limited ability of the parathyroid tissue itself to withstand cryopreservation, and some yet-to-be-defined processes or technologies, the success rate of cryopreserved parathyroid autotransplantation varies between institutions; it is low for some institutions and high for others. Due to the sparsity of data, views vary on which factors most influence the success rate of cryopreserved parathyroid autotransplantation. In this review, we analyzed the following probable influencing factors: ischemic period before cryopreservation; processes of cryopreservation and thawing, including freezing medium; freezing and thawing methods; duration of cryopreservation; examination of the graft before transplantation; graft site; mass of transplanted tissue fragments; blood calcium level; and the evaluation criteria for cryopreserved parathyroid autotransplantation success. Although the effects of these factors are debatable, we hypothesized that examining them in the above-given order to determine whether they affect the success rate of cryopreserved parathyroid autotransplantation could be beneficial to maximizing the success rate. Our findings led us to conclude that cryopreserved parathyroid autotransplantation operations should be standardized. Standardized guidelines for cryopreserved parathyroid autotransplantation that include such factors as ischemic period time, freezing and thawing methods, and recipient status should be established based on a comprehensive analysis of these factors.
摘要:
永久性甲状旁腺功能减退症是甲状腺和甲状旁腺手术的术后并发症,可以通过冷冻保存的甲状旁腺自体移植(CPAT)治愈。然而,由于缺乏统一和规范的指导方针,甲状旁腺组织本身承受低温保存的能力有限,和一些尚未定义的过程或技术,深低温保存的甲状旁腺自体移植的成功率因机构而异;一些机构的成功率较低,而另一些机构的成功率较高。由于数据的稀疏性,对深低温保存甲状旁腺自体移植的成功率影响最大的因素有不同的看法。在这次审查中,我们分析了以下可能的影响因素:冷冻保存前的缺血期;冷冻保存和解冻的过程,包括冷冻培养基;冷冻和解冻方法;冷冻保存的持续时间;移植前检查移植物;移植部位;移植组织碎片的质量;血钙水平;以及冷冻保存的甲状旁腺自体移植成功的评估标准。尽管这些因素的影响尚有争议,我们假设按照上述顺序检查它们,以确定它们是否影响冷冻保存的甲状旁腺自体移植的成功率,可能有利于最大限度地提高成功率.我们的发现使我们得出结论,应标准化冷冻保存的甲状旁腺自体移植手术。冷冻保存甲状旁腺自体移植的标准化指南,包括缺血时间等因素,冷冻和解冻方法,应在对这些因素进行综合分析的基础上确定接受者的地位。