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Routine parathyroid autotransplantation during thyroidectomy.

C Y Lo¹, K Y Lam

¹Division of Endocrine Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, Hong Kong, China.

|March 7, 2001

Summary

Routine parathyroid autotransplantation (PTHAT) during thyroidectomy effectively prevents permanent hypoparathyroidism. However, routine PTHAT leads to a higher rate of temporary hypocalcemia compared to selective PTHAT.

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Area of Science:

Endocrine Surgery
Surgical Outcomes
Thyroid Procedures

Background:

Parathyroid autotransplantation (PTHAT) during thyroidectomy is a known method to decrease permanent hypoparathyroidism.
While selective PTHAT is common, the benefits of routine PTHAT require further documentation.

Purpose of the Study:

To evaluate the outcomes of routine parathyroid autotransplantation (PTHAT) during thyroidectomy.
To compare routine PTHAT with selective PTHAT regarding hypocalcemia and operative time.

Main Methods:

A retrospective study comparing 118 patients undergoing routine PTHAT with 271 patients undergoing selective PTHAT during thyroidectomy.
Outcomes assessed included postoperative hypocalcemia and permanent hypoparathyroidism.

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Main Results:

Routine PTHAT involved autotransplanting at least one parathyroid gland in all patients.
Postoperative hypocalcemia was higher in the routine PTHAT group (25%) compared to the selective PTHAT group (15%).
Permanent hypoparathyroidism rates were similar between routine (1.7%) and selective (1.8%) PTHAT, but operative time was longer with routine PTHAT.

Conclusions:

Both routine and selective parathyroid autotransplantation (PTHAT) during thyroidectomy can achieve low rates of permanent hypoparathyroidism.
Routine PTHAT is associated with a significantly higher incidence of postoperative hypocalcemia and increased operative time.