[Parathyroid autotransplantation during expanded total thyroidectomy for cancer]

Area of Science:

• Endocrine Surgery
• Oncology
• Surgical Pathology

Context:

• Total thyroidectomy for carcinoma poses a risk of parathyroid gland damage, potentially leading to hypoparathyroidism.
• Preserving parathyroid function is crucial for patient well-being post-thyroidectomy.
• Histopathological examination is vital to identify parathyroid glands free from carcinoma invasion.

Purpose:

• To evaluate the efficacy of parathyroid autotransplantation in preventing hypoparathyroidism following total thyroidectomy for carcinoma.
• To assess the impact of autotransplantation on the incidence of permanent hypothyroidism.
• To determine the role of autotransplantation for parathyroid glands that cannot be preserved in situ.

Summary:

• Parathyroid autotransplantation was performed in 28 of 95 patients undergoing total thyroidectomy for carcinoma.
• The procedure served as a supplementary measure in 15 patients and substitutive in 12 patients with total cervical parathyroidectomy.
• Follow-up revealed no signs of hypoparathyroidism in any of the 28 patients.

Impact:

• Significantly reduced the incidence of permanent hypothyroidism from 7% to 2.1% in the studied cohort.
• Demonstrates the value of autotransplantation for preserving parathyroid function when glands are unavoidably removed.
• Highlights the importance of considering autotransplantation for viable parathyroid tissue at risk during oncological thyroid surgery.