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, 艾楊卿, 刁暢, 等. 甲狀腺手術中甲狀旁腺顯露及功能保護的臨床研究. 中國普外基礎與臨床雜志, 2009,16(5):351-355.
5.	王大衛, 王剛, 武林楓, 等. 甲狀腺全切除術中甲狀旁腺的辨識和保護. 中國普通外科雜志, 2013, 22(11):1431-1434.
6.	李文淵. 甲狀腺全切術中甲狀旁腺辨識及原位保護. 中國普通外科雜志, 2015, 24(5):753-756.
7.	中國醫師協會外科醫師分會甲狀腺外科醫師委員會. 甲狀腺手術中甲狀旁腺保護專家共識. 中國實用外科雜志, 2015, 35(7):731-736.
8.	盧春燕, 李志輝, 朱精強, 等. 術后甲狀旁腺機能減退癥的診斷及處理. 中國普外基礎與臨床雜志, 2014, 21(4):501-506.
9.	黃久佐, 汪劭婷, 李小毅. 甲狀腺術后永久性甲狀旁腺功能低減的防治. 中國普外基礎與臨床雜志, 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. 甲狀腺術后甲狀旁腺功能減低致醫療糾紛1例. 中國司法鑒定, 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.	段秀慶, 宋純, 許評, 等. 去甲狀旁腺模型鼠的制備. 中國普外基礎與臨床雜志,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.	高慶軍, 趙代偉, 王南鵬, 等. 同種異體甲狀旁腺組織移植治療甲狀旁腺功能低下的實驗研究. 中國普外基礎與臨床雜志, 2012, 9(10):1079-1084.
18.	王深明, 朱易凡, 王勁松. 用重組表達體系pCKM-mPTH質粒治療甲狀旁腺功能低下癥的實驗研究. 中華醫學雜志, 2004, 84(24):2107-2109.
19.	盧文麗, 潘志強, 方肇勤, 等. 大、小鼠甲狀腺和甲狀旁腺的解剖. 實驗動物與比較醫學,2009, 29(5):310-312.
20.	翟博, 武林楓, 胡鳳麗, 等. 大鼠甲狀旁腺功能低下模型建立方法的比較研究. 中國現代普通外科進展, 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, 蘇艷軍. 甲狀腺手術中甲狀旁腺的功能保護. 國際外科學雜志, 2011, 38(2):73-75.
25.	程若川, 陳會彬, 刁暢, 等. 甲狀腺狀腺全切術后預防性補鈣對甲狀旁腺功能的影響. 中華內分泌外科雜志, 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, 艾楊卿, 刁暢, 等. 甲狀腺手術中甲狀旁腺顯露及功能保護的臨床研究. 中國普外基礎與臨床雜志, 2009,16(5):351-355.
5. 王大衛, 王剛, 武林楓, 等. 甲狀腺全切除術中甲狀旁腺的辨識和保護. 中國普通外科雜志, 2013, 22(11):1431-1434.
6. 李文淵. 甲狀腺全切術中甲狀旁腺辨識及原位保護. 中國普通外科雜志, 2015, 24(5):753-756.
7. 中國醫師協會外科醫師分會甲狀腺外科醫師委員會. 甲狀腺手術中甲狀旁腺保護專家共識. 中國實用外科雜志, 2015, 35(7):731-736.
8. 盧春燕, 李志輝, 朱精強, 等. 術后甲狀旁腺機能減退癥的診斷及處理. 中國普外基礎與臨床雜志, 2014, 21(4):501-506.
9. 黃久佐, 汪劭婷, 李小毅. 甲狀腺術后永久性甲狀旁腺功能低減的防治. 中國普外基礎與臨床雜志, 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. 甲狀腺術后甲狀旁腺功能減低致醫療糾紛1例. 中國司法鑒定, 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. 段秀慶, 宋純, 許評, 等. 去甲狀旁腺模型鼠的制備. 中國普外基礎與臨床雜志,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. 高慶軍, 趙代偉, 王南鵬, 等. 同種異體甲狀旁腺組織移植治療甲狀旁腺功能低下的實驗研究. 中國普外基礎與臨床雜志, 2012, 9(10):1079-1084.
18. 王深明, 朱易凡, 王勁松. 用重組表達體系pCKM-mPTH質粒治療甲狀旁腺功能低下癥的實驗研究. 中華醫學雜志, 2004, 84(24):2107-2109.
19. 盧文麗, 潘志強, 方肇勤, 等. 大、小鼠甲狀腺和甲狀旁腺的解剖. 實驗動物與比較醫學,2009, 29(5):310-312.
20. 翟博, 武林楓, 胡鳳麗, 等. 大鼠甲狀旁腺功能低下模型建立方法的比較研究. 中國現代普通外科進展, 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, 蘇艷軍. 甲狀腺手術中甲狀旁腺的功能保護. 國際外科學雜志, 2011, 38(2):73-75.
25. 程若川, 陳會彬, 刁暢, 等. 甲狀腺狀腺全切術后預防性補鈣對甲狀旁腺功能的影響. 中華內分泌外科雜志, 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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