The Impact of Single Parathyroid Gland Autotransplantation During Thyroid Surgery on Postoperative Hypoparathyroidism: A Multicenter Study

Testini, Mario; Rosato, L; Avenia, Nicola; Burzotta, Francesco; Portincasa, Piero; Piccinni, Giuseppe; Lissidini, Germana; Biondi, Antonio; Gurrado, Angela; Nacchiero, Michele

doi:10.1016/j.transproceed.2006.10.192

Cited by 57 publications

(46 citation statements)

References 34 publications

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“…In these patients, because the posterior capsule is also removed with the thyroid, parathyroid glands are at high risk of injury (33,34). In our study early postoperative hypocalcemia developed in 23.7% of patients without carcinoma, and in 13 of 51 patients (25.5%) with carcinoma.…”

Section: Discussionmentioning

confidence: 47%

Analysis of the factors that have an effect on hypocalcemia following thyroidectomy

Kalyoncu¹,

Gönüllü²,

Gedik³

et al. 2014

UCD

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Objective: The incidence of and risk factors for hypocalcemia following thyroidectomy were evaluated in this study. Material and Methods:One hundred and ninety thyroidectomy patients were evaluated retrospectively for factors that might contribute to postoperative hypocalcemia; age, hyperthyroidism, malignancy, the extent of surgery (total/near total/subtotal thyroidectomy), cervical lymph node dissection, and incidental parathyroidectomy. Results:The rate of transient hypocalcemia/hypoparathyroidism was 19.47%, with a permanent hypoparathyroidism rate of 4.74%. Factors affecting the development of transient hypocalcemia were found as being operated for hyperthyroidism, and use of total thyroidectomy as the surgical method. Total thyroidectomy increased the risk of postoperative hypocalcemia by 3.16 fold. Patients undergoing operations for hyperthyroidism had a 2.3 fold increase, and those undergoing total thyroidectomy had a 3.16 fold risk of postoperative hypocalcemia. Conclusion:Hyperthyroidism surgery and total thyroidectomy lead to a higher risk of developing early postoperative or transient hypocalcemia. According to our results, no significant relationship could be established between any of the study parameters and persistent hypocalcemia.

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Section: Discussionmentioning

confidence: 47%

Analysis of the factors that have an effect on hypocalcemia following thyroidectomy

Kalyoncu¹,

Gönüllü²,

Gedik³

et al. 2014

UCD

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“…The development of permanent hypocalcemia despite all the attention and care encouraged surgeons to autotransplant one or more parathyroid glands during thyroidectomy, and it was reported that the rate of permanent hypoparathyroidism is decreased to below 1% with prophylactic routine autotransplantation (15,(20)(21)(22)(23). There are two studies on the routine application of autotransplantation by Ohman (24) and Kihara (25).…”

Section: Discussionmentioning

confidence: 99%

The risk of hypocalcemia in patients with parathyroid autotransplantation during thyroidectomy

Oran

Yetkın

Mihmanlı

et al. 2016

UCD

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Objective: Thyroidectomy is the most common cause of hypocalcemia. Preservation of parathyroid glands in situ is essential in preventing this complication. The aims of our study were to review patients who underwent parathyroid gland autotransplantation during thyroidectomy, and to compare hypocalcemia rates in patients with and without autotransplantation. Material and Methods:Parathyroid gland autotransplantation was performed in 43 (7.9%) of 543 patients who underwent thyroidectomy between 2008 and 2012.Results: Forty-four parathyroid glands were autotransplanted in 43 patients, including 36 women and 7 men. The median age was 55 (range: 30 to 68). The most common cause of autotransplantation was vascular comprise of the parathyroid gland. Early postoperative hypocalcemia developed in 37% of patients with autotransplantation, and none developed permanent hypocalcemia. Transient and permanent hypocalcemia rates were 9.6% and 0.4% in patients without autotransplantation, respectively. The risk of transient hypocalcemia was significantly high in patients with parathyroid autotransplantation (p<0.001). There was no difference between the two groups in terms of permanent hypocalcemia (p=0.156). Conclusion:Despite meticulous dissection, parathyroid glands can be devascularized or removed inadvertently during thyroidectomy. Parathyroid autotransplantation is the best method to maintain parathyroid gland function. Although the risk of transient hypocalcemia is increased following parathyroid autotransplantation, long-term results are satisfactory. INTRODUCTIONThyroid surgery is the most frequently performed operation in general surgery clinics, and constitute 1% of all medical diseases (1). The second most feared complication of thyroid surgery, following recurrent laryngeal nerve (RLN) injury, is the development of hypocalcemia. The most common cause of hypocalcemia is post-surgery hypoparathyroidism (2). Hypocalcemia may develop in the immediate postoperative period and may improve in several weeks (transient hypocalcemia), or it may persist for more than 6 months after surgery, in which case is called permanent hypocalcemia. Hypocalcemia manifests with paresthesia, mental status changes, neuromuscular irritability, and muscle spasm. Chronic hypocalcemia can lead to cataract formation, calcification in the cerebellum and basal ganglia, peripheral neuropathy, and cardiac problems. These patients require lifelong calcium and vitamin D supplements.

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“…All surgical procedures were performed by skilled surgeons. Accurate dissection and identification of parathyroid glands and their blood supply were obtained by 2.59 loop magnification [8] to leave functioning glands in situ. Nevertheless, in 25 cases, due to intraoperative findings of insufficient blood supply or signs of sufferance (like intracapsular hematoma), or inadvertent excision, one (or more) parathyroid gland was carefully removed and placed in saline solution.…”

Section: Methodsmentioning

confidence: 99%

Parathyroid Reimplantation in Forearm Subcutaneous Tissue During Thyroidectomy: A Simple and Effective Way to Avoid Hypoparathyroidism

et al. 2015

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The Impact of Single Parathyroid Gland Autotransplantation During Thyroid Surgery on Postoperative Hypoparathyroidism: A Multicenter Study

Cited by 57 publications

References 34 publications

Analysis of the factors that have an effect on hypocalcemia following thyroidectomy

Analysis of the factors that have an effect on hypocalcemia following thyroidectomy

The risk of hypocalcemia in patients with parathyroid autotransplantation during thyroidectomy

Parathyroid Reimplantation in Forearm Subcutaneous Tissue During Thyroidectomy: A Simple and Effective Way to Avoid Hypoparathyroidism

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