Does the number of parathyroid glands autotransplanted affect the incidence of hypoparathyroidism and recovery of parathyroid function?

Anping Su; Yanping Gong; Wenshuang Wu; Rixiang Gong; Zhihui Li; Jingqiang Zhu

doi:10.1016/j.surg.2017.12.025

Does the number of parathyroid glands autotransplanted affect the incidence of hypoparathyroidism and recovery of parathyroid function?

Surgery. 2018 Feb 2:S0039-6060(17)30928-5. doi: 10.1016/j.surg.2017.12.025. Online ahead of print.

Authors

Anping Su¹, Yanping Gong¹, Wenshuang Wu¹, Rixiang Gong¹, Zhihui Li¹, Jingqiang Zhu²

Affiliations

¹ Department of Thyroid Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
² Department of Thyroid Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: 17643571@qq.com.

PMID: 29398031
DOI: 10.1016/j.surg.2017.12.025

Abstract

Background: The relationship between the number of parathyroid glands autotransplanted and hypoparathyroidism as well as recovery of parathyroid function is not understood fully. The aim was to ascertain whether the number of autotransplanted glands affected the incidence of hypoparathyroidism and recovery of parathyroid function in long-term follow-up after thyroidectomy.

Methods: A retrospective cohort study included all patients with papillary thyroid carcinoma who underwent first-time total thyroidectomy with central neck dissection between June 2012 and June 2015. The patients were divided into 4 groups (0, 1, 2, and 3) on the basis of the number of parathyroid glands autotransplanted.

Results: Of the 766 patients, 283 (36.9%) had no gland autotransplanted, and 373 (48.7%), 97 (12.7%), and 13 (1.7%) had 1, 2, and 3 glands autotransplanted, respectively. More lymph nodes and more metastatic ones in the central compartment were retrieved in groups 2 and 3 (P < .05). With increasing number of autotransplanted glands, the incidence of transient hypoparathyroidism was 26.1%, 36.2%, 52.6%, and 84.6% (P < .05), and the incidence of permanent hypoparathyroidism was 1.8%, 1.1%, 1.0%, and 0% (P > .05). The recovery rates of serum parathyroid hormone concentration were 84.7%, 82.2%, 82.0%, and 79.2% after 2-year follow-up (P > .05).

Conclusion: Autotransplantation is an effective strategy for restoration of parathyroid function. Transient hypoparathyroidism is positively correlated to the number of autotransplanted parathyroid glands during total thyroidectomy with central neck dissection. There is no increase in permanent hypoparathyroidism in patients with a higher number of autotransplanted glands, despite more extensive lymph node disease. (Surgery 2018;161:XXX-XXX.).