Perioperative Nursing of Patients with Reoperation of Recurrent Parathyroid Carcinoma Invading the Upper Digestive or Respiratory Tract

Abstract

Objective. The aim of this study was to summarize the perioperative nursing care of patients with recurrent parathyroid carcinoma. Methods. A retrospective analysis of 10 patients with recurrent parathyroid carcinoma was performed. The clinical data, diagnosis, treatment process, and nursing process (including clinical nursing intervention of various complications) were analyzed. The nursing experience and methods were discussed, summarized, and analyzed. Results. A total of 10 patients were reviewed (male : female 7 : 3; aged 48.6 ± 14.60 years). The mean interval between the initial operation and reoperation was 2.23 ± 1.65 years. The mean number of operations was 4.00 ± 1.41. Invasion of the trachea or esophagus was evident in 7 patients, larynx in 6 patients, recurrent laryngeal nerve in 1 patient, and cyclic cartilage in 2 patients. Serum calcium range was 3.20–4.68 mmol/L, and parathyroid hormone (PTH) range was 860–2830 pg/ml at admission. 6 patients underwent prophylactic tracheostomy, 2 patients underwent partial laryngectomy, and 2 patients underwent total laryngectomy. 1 patient experienced temporary water-electrolyte disorder and hypoproteinemia. The median serum calcium was 2.28 mmol/L (1.66–3.18 mmol/L) and median PTH level was 82.60 pg/ml (63.70–900.00 pg/ml) postoperatively. Serum PTH and calcium were still higher than the upper limit of normal in 2 patients after surgery. 2 of the other 8 patients relapsed within 8–11 months, and 6 patients remained normal for 11–40 months. Conclusion. For patients with reoperation of recurrent parathyroid carcinoma, high-quality, reasonable, and careful perioperative nursing ensured a successful operation and optimized outcome.