Parathyroid autotransplantation during total thyroidectomy. Results of a retrospective study

Abstract

Authors analyze their experience of parathyroid autotransplantation during total thyroidectomy, with the purpose of seeing whether this practice influenced the rate of postoperative hypocalcemia and/or hypoparathyroidism. We identified three groups of patients: group A, consisting of 57 patients, underwent parathyroid autotransplantation during total thyroidectomy; group B consisting of 87 patients not submitted to intraoperative autotransplantation in whom, as an incidental finding, a parathyroid gland was detected in the surgical specimen; group C consisted of 100 patients who did not undergo autotransplantation and whose surgical specimens were not found to contain parathyroid glands. The three groups were compared for sex and age as well as for a series of clinical and laboratory parameters on the first three postoperative days and at six months after surgery. The rate of permanent hypoparathyroidism was 3.5% in Group A, 3.45% in Group B, and 1% in Group C. Multivariate analysis revealed that all three groups showed postoperative recovery of calcium levels, although the rate and extent of this recovery differed between them. The control group showed a more rapid and more complete recovery of serum calcium values compared with Groups A and B. Calcium recovery in Groups A and B was comparable, in terms of both rate and extent. The same pattern of results emerged for the iPTH values. The analysis of the data showed that there were no significant differences in the analyzed parameters between Groups A and B. This suggests that parathyroid autotransplantation does not influence the rate of postoperative hypocalcemia and/or hypoparathyroidism.

Prolonged Duration of Surgery Predicts Postoperative Hypoparathyroidism among Patients Undergoing Total Thyroidectomy in a Tertiary Referral Centre

“…These relations have all been demonstrated before by several other studies [2, 4, 7-10, 14, 15, 18-20]. Predictors of permanent hypoparathyroidism were prolonged duration of surgery and the performance of combined central and lateral neck dissection.…”

Incidental thyroid carcinomas. A retrospective study

“…The incidence of carcinomas in the cervicomediastinal goiter compared with benign thyroid cervical-mediastinum disease, is around 12.1% (50,51). The association with parathyroid diseases (52)(53)(54)(55)(56) and lymphocytic thyroiditis (57, 58) is also described.…”

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

“…23 18). Intraoperative PG managements did neither significantly differ between groups: (a) 96 PGs were autotransplanted in 76 patients of group L and 101 PGs were autotransplanted in 83 patients of group C (P = .50), (b) 181 (86.2%) patients in group L and 189 (90.0%) patients in group C had at least one viable PG preserved in situ (P = .…”

“…Intraoperative PG managements did neither significantly differ between groups: (a) 96 PGs were autotransplanted in 76 patients of group L and 101 PGs were autotransplanted in 83 patients of group C (P = .50), (b) 181 (86.2%) patients in group L and 189 (90.0%) patients in group C had at least one viable PG preserved in situ (P = . 23 18). Notably, the PH rate did not significantly differ in patients who had received unilateral CND (47 patients in group L and 26 patients in group C) or in patients who had received bilateral CND (11 patients in group L and 8 patients in group C).…”