The risk of hypocalcemia in patients with parathyroid autotransplantation during thyroidectomy

Abstract

Objective: Thyroidectomy is the most common cause of hypocalcemia. Preservation of parathyroid glands in situ is important in preventing this complication. The aims of our study were to review patients who underwent parathyroid gland autotransplantation during thyroidectomy and to compare the hypocalcemia rates of the patients with and without autotransplanted.

Material and Methods: Parathyroid gland autotransplantation was performed in 43 (% 7.9) of 543 patients who underwent thyroidectomy between 2008 and 2012.

Results: A total of 44 parathyroid glands were autotransplanted in 43 patients. There were 36 women and 7 men. The median age was 55 (range: 30 to 68). The most common cause of autotransplantation was the vascular insufficiency of the parathyroid gland. Early postoperative hypocalcemia was developed in 37 % of the patients with autotransplantation and no permanent hypocalcemia was occured. Transient and permanent hypocalcemia rates were 9,6 % and 0,4 % in patients without autotransplantation, respectively. The risk of transient hypocalcemia was significantly high in patients with parathyroid autotransplantation (p< 0.001). There was no difference between the two groups in terms of permanent hypocalcemia (p=0.156).

Conclusion: Despite meticulous dissection parathyroid glands can be devascularized or removed inadvertently during thyroidectomy. Parathyroid autotransplantation is the best way for protection of the function of parathyroid glands. Although the risk of transient hypocalcemia is increased following parathyroid autotransplantation, long term results are satisfactory.

Ethics committee approval was received for this study from the ethics committee of Şişli Etfal Training and Research Hospital.

Written informed consent was obtained from patients who participated in this study.

Externally peer-reviewed.

Concept - E. O., G. Y., M. U., M. M.; Design - E. O., G. Y., M. U., M.M.; Supervision - F.C., N.A.; Data Collection and/or Processing - N.A., E.P., B.Ç., E.O.; Analysis and/or Interpretation - F.C., E.O.; Literature Review - N.A., E.P., B.Ç.; Writer - E.O.; Critical Review - M.U., G.Y., M.M.; Other - F.C.

No conflict of interest was declared by the authors.

The authors declared that this study has received no financial support.