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ORIGINAL RESEARCH article
Front. Surg.
Sec. Otorhinolaryngology - Head and Neck Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1565581
Selective parathyroid autotransplantation prevent permanent hypoparathyroidism after total thyroidectomy with central neck dissection
Provisionally accepted- 1Nursing Department, the Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- 2Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Hangzhou, China
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The impact of parathyroid gland autotransplantation on permanent hypoparathyroidism remains incompletely understood. This study aimed to ascertain how selective autotransplantation of parathyroid glands affects the occurrence of permanent hypoparathyroidism after total thyroidectomy with central neck dissection (CND).: A retrospective cohort study encompassed consecutive patients with papillary thyroid carcinoma who underwent primary total thyroidectomy plus CND from January 2008 to December 2010 and January 2012 to December 2019. Patients were categorized into two groups (0 and ≥ 1 parathyroid glands autotransplanted, respectively). Result: The autotransplantation group comprised 501 patients, while the non-autotransplantation group comprised 652 patients. The autotransplantation group showed significantly lower permanent hypoparathyroidism than the non-autotransplantation group [1.2% (6 of 501) vs. 4.4% (29 of 652), P=0.001]. Out of the total 1,153 patients, 652 (56.5%) had no autotransplanted glands, and 358(31.0%), 136 (11.8%), and 7 (0.6%) had 1, 2, and 3 glands autotransplanted, respectively. As the number of autotransplanted glands increased (from 0 to 3), the prevalence of permanent hypoparathyroidism was 4.4% (29 of 652), 1.4% (5 of 358), 0.7% (1 of 136), and 0.0% (0 of 7), respectively (P=0.016). Multivariate logistic analysis revealed that parathyroid autotransplantation independently prevented postoperative permanent hypoparathyroidism.Selective parathyroid autotransplantation is associated with a lower risk of permanent postoperative hypoparathyroidism. Autotransplantation is recommended for parathyroid glands that are devascularized or challenging to preserve in their original location.
Keywords: Parathyroid gland, autotransplantation, In situ preservation, Transient hypoparathyroidism, Permanent hypoparathyroidism
Received: 23 Jan 2025; Accepted: 10 Apr 2025.
Copyright: © 2025 Sun, Gao, Xiao, Xie, Zhuang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: JianBiao Wang, Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Hangzhou, China
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