Establishment of an Animal Model of Temporary Hypoparathyroidism Following Thyroid Operation in Rabbits_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 SUYan-jun , QIANJun , ZHANGJian-ming , DIAOChang , YANGTing-ting , LIUBin ,  CHENGRuo-chuan

Department of Thyroid Surgery, The 1st Affiliated Hospital of Kunming Medical University, Clinical Research Center of Thyroid Surgery in Yunnan Province, Kunming 650031, Yunnan Province, China;

Corresponding author：

CHENGRuo-chuan, Email: cruochuan@foxmail.com

Keywords：

Thyroidectomy; Complication; Hypoparathyroidism; Animal model

DOI：

10.7507/1007-9424.20160306

Video：

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Objective To establish a stable laboratory model of temporary hypoparathyroidism following thyroid operation in rabbits. Methods Twenty New Zealand white rabbits were randomized into 2 groups (the four parathyroid glands injured group and the two inferior parathyroid glands injured group, n=10 for each group). In the two inferior parathyroid glands injured group, blood supply vessels of the two inferior parathyroid glands were injured with ligation. In the four parathyroid glands injured group, total thyroidectomy (including two superior parathyroid glands) were performed and blood supply vessels of the two inferior parathyroid glands were injured with ligation. The number of the identified parathyroid glands were counted during operation. Serum calcium and parathyroid hormone (PTH) were evaluated preoperatively and postoperatively on 1 d, 2 d, 3 d, 5 d and in 1 week, 2 weeks, 3 weeks, and 4 weeks. Model achievement rate were calculated. Results Four parathyroid glands were identified in rabbits. The two superior parathyroid glands were in thyroid tissue which were identified with histology, and the two inferior parathyroid glands located in the fascia plane between the sternohyoid, sternothyroid muscles and the carotid artery which can easily be identified with naked eye. There were no significant difference in preoperative calcium and PTH between the two groups (P > 0.05). In the two inferior parathyroid glands injured group, significantly decreased in serum calcium were observed on 1 d, 2 d and 3 d after operation (P < 0.05). In the four parathyroid glands injured group, significantly decreased in blood calcium were observed on 1 d, 2 d, 3 d and 5 d after operation (P < 0.05). The lowest level of serum calcium was observed on 1 d in two groups. Postoperative serum PTH were significantly declined in two groups on 1 d, 2 d, 3 d, 5 d, and in 1 week, 2 weeks and 3 weeks (P < 0.05). The lowest serum PTH was also observed on 1 d in two groups. Significantly lower serum PTH were found in the four parathyroid glands injured group on 1 d, 2 d and 3 d than in the two inferior parathyroid glands injured group (P < 0.05). Lower PTH level were found in the four parathyroid glands injured group on 5 d, and in 1 week, 2 weeks, 3 weeks and 4 weeks, but no significance (P > 0.05). Positive correlation between serum calcium and PTH were noticed (r=0.771, P=0.000). Model achievement rate were higher on 3 d and 5 d in the four parathyroid glands injured group than that of the two inferior parathyroid glands injured group (P < 0.05). Conclusions Stable animal model of temporary hypoparathyroidism following thyroidectomy can be established by total-thyroidectomy plus ligation the blood vessels of the two inferior parathyroid glands. This model can be used for further study.

Citation： SU Yan-jun, QIAN Jun, ZHANG Jian-ming, DIAO Chang, YANG Ting-ting, LIU Bin, CHENG Ruo-chuan. Establishment of an Animal Model of Temporary Hypoparathyroidism Following Thyroid Operation in Rabbits. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(10): 1193-1197. doi: 10.7507/1007-9424.20160306 Copy

1.	Song CM, Jung JH, Ji YB, et al. Relationship between hypoparath-yroidism and the number of parathyroid glandspreserved during thyroidectomy. World J Surg Oncol, 2014, 12:200.
2.	Palazzo FF, Sywak MS, Sidhu SB, et al. Parathyroid autotransplan-tation during total thyroidectomydoes the number of glands transplanted affect outcome? World J Surg, 2005, 29(5):629-631.
3.	Pfleiderer AG, Ahmad N, Draper MR, et al. The timing of calcium measurements in helping to predict temporary and permanent hypocalcaemia in patients having completion and total thyroidectomies. Ann R Coll Surg Engl, 2009, 91(2):140-146.
4.	程若川, 艾杨卿, 刁畅, 等. 甲状腺手术中甲状旁腺显露及功能保护的临床研究. 中国普外基础与临床杂志, 2009,16(5):351-355.
5.	王大卫, 王刚, 武林枫, 等. 甲状腺全切除术中甲状旁腺的辨识和保护. 中国普通外科杂志, 2013, 22(11):1431-1434.
6.	李文渊. 甲状腺全切术中甲状旁腺辨识及原位保护. 中国普通外科杂志, 2015, 24(5):753-756.
7.	中国医师协会外科医师分会甲状腺外科医师委员会. 甲状腺手术中甲状旁腺保护专家共识. 中国实用外科杂志, 2015, 35(7):731-736.
8.	卢春燕, 李志辉, 朱精强, 等. 术后甲状旁腺机能减退症的诊断及处理. 中国普外基础与临床杂志, 2014, 21(4):501-506.
9.	黄久佐, 汪劭婷, 李小毅. 甲状腺术后永久性甲状旁腺功能低减的防治. 中国普外基础与临床杂志, 2012, 19(8):890-893.
10.	Youngwirth L, Benavidez J, Sippel R, et al. Parathyroid hormone deficiency after total thyroidectomy:incidence and time. J Surg Res, 2010, 163(1):69-71.
11.	程亦斌. 甲状腺术后甲状旁腺功能减低致医疗纠纷1例. 中国司法鉴定, 2008,1:90-91.
12.	Thomusch O, Machens A, Sekulla C, et al. The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery:a multivariate analysis of 5846 consecutive patients. Surgery, 2003, 133(2):180-185.
13.	段秀庆, 宋纯, 许评, 等. 去甲状旁腺模型鼠的制备. 中国普外基础与临床杂志,2005,12(4):393-394.
14.	Bas S, Aguilera-Tejero E, Bas A, et al. The influence of the progression of secondary hyperparathyroidism on the set point of the parathyroid hormone-calcium curve. J Endocrinol, 2005, 184(1):241-247.
15.	Bai RJ, Cheng XG, Yan D, et al. Rabbit model of primary hyperparathyroidism induced by high-phosphate diet. Domest Anim Endocrinol, 2012, 42(1):20-30.
16.	Jara A, González S, Felsenfeld AJ, et al. Failure of high doses of calcitriol and hypercalcaemia to induce apoptosis in hyperplastic parathyroid glands of azotaemic rats. Nephrol Dial Transplant, 2001, 16(3):506-512.
17.	高庆军, 赵代伟, 王南鹏, 等. 同种异体甲状旁腺组织移植治疗甲状旁腺功能低下的实验研究. 中国普外基础与临床杂志, 2012, 9(10):1079-1084.
18.	王深明, 朱易凡, 王劲松. 用重组表达体系pCKM-mPTH质粒治疗甲状旁腺功能低下症的实验研究. 中华医学杂志, 2004, 84(24):2107-2109.
19.	卢文丽, 潘志强, 方肇勤, 等. 大、小鼠甲状腺和甲状旁腺的解剖. 实验动物与比较医学,2009, 29(5):310-312.
20.	翟博, 武林枫, 胡凤丽, 等. 大鼠甲状旁腺功能低下模型建立方法的比较研究. 中国现代普通外科进展, 2005, 8(4):245.
21.	Tan SQ, Thomas D, Jao W, et al. Surgical thyroparathyroidectomy of the rabbit. Am J Physiol, 1987, 252(4 Pt 2):F761-F767.
22.	Shoumura S, Emura S, Isono H. The parathyroid gland under normal and experimental conditions. Kaibogaku Zasshi, 1993, 68(1):25-29.
23.	Promberger R, Ott J, Kober F, et al. Normal parathyroid hormone levels do not exclude permanent hypoparathyroidism after thyroidectomy. Thyroid, 2011, 21(2):145-150.
24.	程若川, 苏艳军. 甲状腺手术中甲状旁腺的功能保护. 国际外科学杂志, 2011, 38(2):73-75.
25.	程若川, 陈会彬, 刁畅, 等. 甲状腺状腺全切术后预防性补钙对甲状旁腺功能的影响. 中华内分泌外科杂志, 2012, 6(4):243-246.

1. Song CM, Jung JH, Ji YB, et al. Relationship between hypoparath-yroidism and the number of parathyroid glandspreserved during thyroidectomy. World J Surg Oncol, 2014, 12:200.
2. Palazzo FF, Sywak MS, Sidhu SB, et al. Parathyroid autotransplan-tation during total thyroidectomydoes the number of glands transplanted affect outcome? World J Surg, 2005, 29(5):629-631.
3. Pfleiderer AG, Ahmad N, Draper MR, et al. The timing of calcium measurements in helping to predict temporary and permanent hypocalcaemia in patients having completion and total thyroidectomies. Ann R Coll Surg Engl, 2009, 91(2):140-146.
4. 程若川, 艾杨卿, 刁畅, 等. 甲状腺手术中甲状旁腺显露及功能保护的临床研究. 中国普外基础与临床杂志, 2009,16(5):351-355.
5. 王大卫, 王刚, 武林枫, 等. 甲状腺全切除术中甲状旁腺的辨识和保护. 中国普通外科杂志, 2013, 22(11):1431-1434.
6. 李文渊. 甲状腺全切术中甲状旁腺辨识及原位保护. 中国普通外科杂志, 2015, 24(5):753-756.
7. 中国医师协会外科医师分会甲状腺外科医师委员会. 甲状腺手术中甲状旁腺保护专家共识. 中国实用外科杂志, 2015, 35(7):731-736.
8. 卢春燕, 李志辉, 朱精强, 等. 术后甲状旁腺机能减退症的诊断及处理. 中国普外基础与临床杂志, 2014, 21(4):501-506.
9. 黄久佐, 汪劭婷, 李小毅. 甲状腺术后永久性甲状旁腺功能低减的防治. 中国普外基础与临床杂志, 2012, 19(8):890-893.
10. Youngwirth L, Benavidez J, Sippel R, et al. Parathyroid hormone deficiency after total thyroidectomy:incidence and time. J Surg Res, 2010, 163(1):69-71.
11. 程亦斌. 甲状腺术后甲状旁腺功能减低致医疗纠纷1例. 中国司法鉴定, 2008,1:90-91.
12. Thomusch O, Machens A, Sekulla C, et al. The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery:a multivariate analysis of 5846 consecutive patients. Surgery, 2003, 133(2):180-185.
13. 段秀庆, 宋纯, 许评, 等. 去甲状旁腺模型鼠的制备. 中国普外基础与临床杂志,2005,12(4):393-394.
14. Bas S, Aguilera-Tejero E, Bas A, et al. The influence of the progression of secondary hyperparathyroidism on the set point of the parathyroid hormone-calcium curve. J Endocrinol, 2005, 184(1):241-247.
15. Bai RJ, Cheng XG, Yan D, et al. Rabbit model of primary hyperparathyroidism induced by high-phosphate diet. Domest Anim Endocrinol, 2012, 42(1):20-30.
16. Jara A, González S, Felsenfeld AJ, et al. Failure of high doses of calcitriol and hypercalcaemia to induce apoptosis in hyperplastic parathyroid glands of azotaemic rats. Nephrol Dial Transplant, 2001, 16(3):506-512.
17. 高庆军, 赵代伟, 王南鹏, 等. 同种异体甲状旁腺组织移植治疗甲状旁腺功能低下的实验研究. 中国普外基础与临床杂志, 2012, 9(10):1079-1084.
18. 王深明, 朱易凡, 王劲松. 用重组表达体系pCKM-mPTH质粒治疗甲状旁腺功能低下症的实验研究. 中华医学杂志, 2004, 84(24):2107-2109.
19. 卢文丽, 潘志强, 方肇勤, 等. 大、小鼠甲状腺和甲状旁腺的解剖. 实验动物与比较医学,2009, 29(5):310-312.
20. 翟博, 武林枫, 胡凤丽, 等. 大鼠甲状旁腺功能低下模型建立方法的比较研究. 中国现代普通外科进展, 2005, 8(4):245.
21. Tan SQ, Thomas D, Jao W, et al. Surgical thyroparathyroidectomy of the rabbit. Am J Physiol, 1987, 252(4 Pt 2):F761-F767.
22. Shoumura S, Emura S, Isono H. The parathyroid gland under normal and experimental conditions. Kaibogaku Zasshi, 1993, 68(1):25-29.
23. Promberger R, Ott J, Kober F, et al. Normal parathyroid hormone levels do not exclude permanent hypoparathyroidism after thyroidectomy. Thyroid, 2011, 21(2):145-150.
24. 程若川, 苏艳军. 甲状腺手术中甲状旁腺的功能保护. 国际外科学杂志, 2011, 38(2):73-75.
25. 程若川, 陈会彬, 刁畅, 等. 甲状腺状腺全切术后预防性补钙对甲状旁腺功能的影响. 中华内分泌外科杂志, 2012, 6(4):243-246.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Establishment of an Animal Model of Temporary Hypoparathyroidism Following Thyroid Operation in Rabbits

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