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Parathyroid autotransplantation during thyroid surgery.

A R Shaha1, C Burnett, B M Jaffe

  • 1Department of Surgery, SUNY-HSC, Brooklyn 11203.

Journal of Surgical Oncology
|January 1, 1991
PubMed
Summary
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Parathyroid autotransplantation effectively preserves parathyroid function after thyroid surgery. This technique reduces permanent hypoparathyroidism, a common complication, ensuring better patient outcomes.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Head and Neck Surgery

Background:

  • Permanent hypoparathyroidism is a significant complication of thyroid surgery, affecting 3-25% of patients.
  • Causes include inadvertent removal, ligation of blood supply, or hematoma.
  • Meticulous surgical technique can minimize parathyroid injury.

Purpose of the Study:

  • To evaluate the efficacy of parathyroid autotransplantation in preserving parathyroid function after thyroidectomy.
  • To establish autotransplantation as a reliable method for managing devascularized or damaged parathyroid glands.

Main Methods:

  • Over 7 years, 250 thyroidectomies were performed with attempts to identify and preserve parathyroid glands.
  • Devascularized or damaged parathyroids were autotransplanted into the sternomastoid muscle.

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  • Frozen section confirmed parathyroid tissue before transplantation.

    • Main Results:

    • Parathyroid autotransplantation was performed in 15 cases, including instances with single parathyroid injury.
    • Only one patient experienced temporary hypoparathyroidism, resolving with calcium supplementation.
    • The remaining 14 patients recovered without complications.

    Conclusions:

    • Autotransplantation is a highly effective method for preserving parathyroid function when glands are devascularized or damaged during thyroid surgery.
    • Familiarity with parathyroid autotransplantation techniques is crucial for thyroid surgeons.
    • This procedure minimizes the incidence of permanent hypoparathyroidism, improving surgical outcomes.