Effect of autotransplantation of a parathyroid gland on hypoparathyroidism after total thyroidectomy

被引:24
作者
Su, Anping [1 ]
Gong, Yanping [1 ]
Wu, Wenshuang [1 ]
Gong, Rixiang [1 ]
Li, Zhihui [1 ]
Zhu, Jingqiang [1 ]
机构
[1] Sichuan Univ, West China Hosp, Dept Thyroid Surg, Chengdu, Sichuan, Peoples R China
关键词
autotransplantation; hypoparathyroidism; parathyroid gland; CENTRAL NECK DISSECTION; TERM-FOLLOW-UP; LYMPH-NODE DISSECTION; RISK-FACTORS; POSTOPERATIVE HYPOPARATHYROIDISM; INADVERTENT PARATHYROIDECTOMY; PERMANENT HYPOPARATHYROIDISM; CARCINOMA; SURGERY; CANCER;
D O I
10.1530/EC-17-0313
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The effect of parathyroid autotransplantation on hypoparathyroidism is not fully understood. The purpose of the study was to determine the effect of autotransplantation of a parathyroid gland on the incidence of hypoparathyroidism and recovery of parathyroid function at 6 months after total thyroidectomy with central neck dissection for papillary thyroid carcinoma. Methods: All patients with autotransplantation of a parathyroid gland (no inadvertent parathyroidectomy) (group A), in situ preservation of all parathyroid glands (no autotransplantation and inadvertent parathyroidectomy) (group B) or inadvertent removal of a parathyroid gland (no autotransplantation) (group C) who underwent first-time total thyroidectomy with central neck dissection for papillary thyroid carcinoma between January 2013 and June 2016 were included retrospectively. Results: Of the 702 patients, 383, 297 and 22 were respectively included in the groups A, B and C. The overall rates of transient and permanent hypoparathyroidism were 37.6% and 1.0%. The incidence of transient hypoparathyroidism was 43.9, 29.0 and 45.5% (A vs B, P = 0.000; A vs C, P = 1.000), and the incidence of permanent hypoparathyroidism was 1.0, 0.7 and 4.5% (P > 0.05). The recovery rates of serum parathyroid hormone levels were 71.4, 72.2 and 66.0% at 6-month follow-up (P > 0.05). Conclusion: Autotransplantation of a parathyroid gland does not affect the incidence of permanent hypoparathyroidism, but increases the risk of transient hypoparathyroidism when the rest of parathyroid glands are preserved in situ. At least 2 parathyroid glands should be preserved during total thyroidectomy with central neck dissection to prevent permanent hypoparathyroidism.
引用
收藏
页码:286 / 294
页数:9
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