The Effect of Parathyroid Gland Autotransplantation on Hypoparathyroidism After Thyroid Surgery for Papillary Thyroid Carcinoma

Abstract

Purpose

There are some controversies over the relationship between parathyroid gland autotransplantation and permanent hypoparathyroidism. This study aimed to explore the relationship between parathyroid gland autotransplantation and postoperative hypoparathyroidism.

Patients and Methods

We performed a retrospective analysis of patients who underwent initial thyroid surgery for papillary thyroid carcinoma from January 2014 to December 2018. Patients were divided into 4 groups according to the number of autotransplanted parathyroid glands (group 1: 0 autotransplanted parathyroid gland, group 2: 1 autotransplanted parathyroid gland, group 3: 2 autotransplanted parathyroid glands, group 4: 3 autotransplanted parathyroid glands). Clinical data were analyzed among the four groups.

Results

The more parathyroid glands were transplanted, the higher the incidence of immediate hypoparathyroidism was (group 1: 32.9%, group 2: 52.9%, group 3: 65.8%, group 4: 82.4%; P_{group 1 vs group 2} < 0.001, P_{group 2 vs group 3} = 0.012, P_{group 3 vs group 4} = 0.17). Parathyroid gland autotransplantation did not affect the incidence of permanent hypoparathyroidism (group 1: 1.4%, group 2: 1.3%, group 3: 0.9%, group 4: 0%; P_{group 1 vs group 2} > 0.99, P_{group 2 vs group 3} > 0.99, P_{group 3 vs group 4} > 0.99).

Conclusion

The number of autotransplanted parathyroid glands was positively associated with the incidence of postoperative immediate hypoparathyroidism. Parathyroid gland autotransplantation was not associated with permanent hypoparathyroidism.

Keywords:

• parathyroid gland
• autotransplantation
• hypoparathyroidism
• thyroid surgery

Acknowledgments

The authors thank the patients for their participation.

Abbreviations

PG, parathyroid gland; PGA, parathyroid gland autotransplantation; APG, autotransplanted parathyroid gland; TT total thyroidectomy; BCND bilateral central lymph node dissection; PTH, parathyroid hormone; IEPG, inadvertently excisional parathyroid gland; ISPG, parathyroid gland in site; F, female; M male; BMI body mass index; ULND unilateral neck lymph node dissection (compartments II–V); BLND bilateral neck lymph node dissection (compartments II–V).

Data Sharing Statement

All data and code used and analyzed during the study are available from the corresponding author by reasonable request.

Ethics Approval and Informed Consent

The study was approved by the Medical Ethics Committee of Chengdu Third People’s Hospital (No. 2019-S-90). This study was conducted in accordance with the Declaration of Helsinki.

Consent for Publication

All authors have reviewed the final version of the manuscript and are in agreement its’ content and submission.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Dr Bin Wang reports grants from CHINA HEALTH PROMOTION FOUNDATION, during the conduct of the study. Dr Jian Wu reports grants from Scientific Research Fund of the Department of Science and Technology of Chengdu City, grants from Science and Technology Program of Science & Technology Department of Sichuan Province, during the conduct of the study. The authors report no conflicts of interest in this work.