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Parathyroid Autotransplantation During Thyroid Surgery: A Novel Technique Using a Cell Culture Nutrient Solution
Fausto Famà1,2, Marco Cicciù3, Francesca Polito4
1Department of Human Pathology, University Hospital of Messina, Via Consolare Valeria, 1, 98125, Messina, Italy. famafausto@yahoo.it.
World Journal of Surgery
|October 14, 2016
Summary
Parathyroid autotransplantation into the sternocleidomastoid muscle is effective in preventing permanent hypoparathyroidism. Using a cell nutrient solution before transplanting parathyroid glands significantly reduces hypocalcemia rates.
Area of Science:
- Endocrinology
- Surgical Oncology
- Transplantation Medicine
Background:
- Parathyroid autotransplantation is a common procedure following thyroidectomy.
- Damage or removal of parathyroid glands can lead to hypoparathyroidism.
- The sternocleidomastoid muscle offers a convenient site for parathyroid autotransplantation.
Purpose of the Study:
- To evaluate the efficacy of parathyroid autotransplantation in preventing hypoparathyroidism after total thyroidectomy.
- To assess the benefit of using a cell culture nutrient solution during parathyroid autotransplantation.
- To compare outcomes between patients undergoing parathyroid autotransplantation with and without nutrient solution treatment.
Main Methods:
- Retrospective review of 396 patients undergoing total thyroidectomy for benign thyroid disease.
- Parathyroid glands damaged or removed were transplanted into the sternocleidomastoid muscle.
- A subset of transplanted glands were pre-treated with a cell culture nutrient solution (Group A) and compared to standard autotransplantation (control group C) and no transplantation (Group B).
Main Results:
- A significantly lower rate of hypocalcemia was observed in patients who underwent parathyroid autotransplantation with nutrient solution (Group A) compared to those without transplantation (Group B) (P < 0.001).
- No definitive hypoparathyroidism occurred in Group A, while 8.1% of patients in Group B and 3/42 in the control group (Group C) experienced definitive hypoparathyroidism.
- Statistically significant differences in pre- and postoperative calcium levels were noted across all groups (P < 0.001).
Conclusions:
- Routine parathyroid autotransplantation is recommended when vascular damage is suspected or certain.
- Pre-treatment with a cell culture nutrient solution before gland transplantation can reduce the incidence of permanent hypoparathyroidism.
- Transplantation into the sternocleidomastoid muscle is an effective and time-saving surgical approach.
