[Hypoparathyroidism after thyroid surgery]. / L'hypoparathyroidie apres la chirurgie thyroidienne.

The authors report their experience of hypoparathyroidism in thyroïd surgery: 538 patients underwent thyroidectomy, including 45% bilateral resections. In post operative period, accurate tests allowed to detect non permanent hypocalcemias in 60% of cases. Severe hypocalcemia (1.60 mmol/l) is necessary to engage a treatment by vitamin D. So, a soft thyroid microsurgery is the only one manner to preserve parathyroid stock. 46 patients had parathyroid transplantation, but the evaluation is difficult, because the amount of parathyroid gland without ischemia, left into the neck, is unknown. In summary, this technique is effective, but often useless in thyroid surgery.

[Value of deliberate normovolemic hemodilution associated with a capillary vasoconstrictor, ornipressin, in surgery of the spine]. / Intérêt de l'hémodilution normovolémique intentionnelle associée à un vaso-constricteur capillaire, l'ornipressine, dans la chirurgie du rachis.

This study of sixty-seven children divided in two groups compared the blood loss and the amount of blood transfused during and after the operation. The operations were carried out without haemodilution nor the local injection of vasoconstrictor (twenty-four patients) and following haemodilution and the local injection of vasoconstrictor (forty-three patients). The blood loss during operation was 344 +/- 455 ml per vertebra in the first group, and 151 +/- 54 ml in the second. The blood loss in the post operative period did not seem to be modified by haemodilution, as the level of hemoglobulin was virtually the same in the two groups eleven days after the operation. A mean of seven units of blood were transfused to the first group, whilst only three in the second group. In the post-operative period, both groups received a mean of one unit each. Associating haemodilution and a vasoconstrictor, ornipressin, reduced very significantly the need for homologous blood.