Abstract
Purpose: The relationship between the selective parathyroid gland (PG) autotransplantation and hypoparathyroidism is still not completely clear. The aim was to ascertain whether the number of autotransplanted PGs affected the incidence of hypoparathyroidism and recovery of parathyroid function in the long-term for patients with papillary thyroid carcinoma (PTC).Methods: A retrospective cohort study included all patients with PTC who had underwent primary total thyroidectomy with central neck dissection between January 2013 and December 2017. The patients were divided into three groups (0, 1, and 2 PGs autotransplanted, respectively).Results: Of the 2,477 patients, 634 (25.6%) received no PG autotransplantation, 1,078 (43.5%) and 765 (30.9%) were autotransplanted 1 and 2 PGs, respectively, and the incidence of permanent hypoparathyroidism (>1 year) was 1.7%, 0.7%, and 0.4% (P = 0.0228). Both 1 or 2 PGs autotransplanted increased the incidence of transient biochemical hypoparathyroidism (odds ratio [OR], 1.567; 95% confidence interval [CI], 1.258–1.953; P < 0.0001; OR, 2.983; 95% CI, 2.336–3.810; P < 0.0001, respectively) but reduced the incidence of permanent hypoparathyroidism (OR, 0.373; 95% CI, 0.145–0.958; P = 0.0404; OR, 0.144; 95% CI, 0.037–0.560; P = 0.0052, respectively). Both 1 or 2 PGs autotransplanted did not independently influence the occurrence of hypocalcemia symptoms.Conclusion: Selective parathyroid autotransplantation is less likely to lead to post-operative symptomatic hypocalcemia, although it could lead to a transient decrease in parathyroid hormone. However, in the long run, it is still an effective strategy to preserve parathyroid function.
Highlights
The treatment of the rapidly increasing incidence of papillary thyroid carcinoma (PTC) has led to the widespread use of total thyroidectomy with central neck dissection (CND) [1]. This surgical treatment increases the risk of post-operative hypoparathyroidism, especially when bilateral central neck dissection is performed [2]
Some authors even advocated routine parathyroid gland (PG) autotransplantation due to their belief that the function of the autotransplanted PGs is more predictable than the PGs which is left in situ with a possibly insufficient blood supply, which would reduce the incidence of hypoparathyroidism [9]
All patients who participated in this study obtained the informed consent, that is their clinical data could be used for medical analysis
Summary
The treatment of the rapidly increasing incidence of papillary thyroid carcinoma (PTC) has led to the widespread use of total thyroidectomy with central neck dissection (CND) [1]. This surgical treatment increases the risk of post-operative hypoparathyroidism, especially when bilateral central neck dissection is performed [2]. Some authors even advocated routine PG autotransplantation due to their belief that the function of the autotransplanted PGs is more predictable than the PGs which is left in situ with a possibly insufficient blood supply, which would reduce the incidence of hypoparathyroidism [9]. The association between the number of autotransplanted PGs and recovery of parathyroid function is still controversial
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
