Failure of fragmented parathyroid gland autotransplantation to prevent permanent hypoparathyroidism after total thyroidectomy

Abstract

The prevalence of parathyroid failure syndromes after total thyroidectomy was similar whether a parathyroid gland was inadvertently excised or autotransplanted. Autotransplantation did not influence the permanent hypoparathyroidism rate.

Mortality in patients with permanent hypoparathyroidism after total thyroidectomy

“…Using long‐term treatment with vitamin D as the definition of hypoparathyroidism, the incidence of this complication in patients undergoing total thyroidectomy for benign disease was 5·0 per cent. This is clearly a high rate, but in agreement with an observational study, two RCTs for Graves' disease and a meta‐analysis. However, in a recent Cochrane review of the risk of permanent hypoparathyroidism in patients included in RCTs, comparing total or near‐total thyroidectomy with subtotal thyroidectomy among those with non‐toxic nodular goitre, the risk was below 1 per cent.…”

Effect of autotransplantation of a parathyroid gland on hypoparathyroidism after total thyroidectomy

“…However, several studies demonstrated that parathyroid autotransplantation increased the risk of transient and permanent hypoparathyroidism (16,17,18). In addition, a recent study found similar incidence of permanent hypoparathyriodism whether a parathyroid gland was autotransplanted or inadvertently excised (19). Inadvertent parathyroidectomy is commonly regarded as one of the risk factors of postoperative hypoparathyroidism (20,21).…”

Comparison of hypocalcemia rates between LigaSure and clamp‐and‐tie hemostatic technique in total thyroidectomies

“…Additionally, some data indicate that leaving the PG well vascularized in situ is beneficial. 14,22,23 In this study, the preferred surgical strategy for preserving PG function was in situ preservation. During surgery, blood vessels near the PG were individually separated to avoid interference with the blood supply, and the thyroid capsule was carefully inspected to determine whether the PG had adhered to the capsule.…”