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. 2014 Jul 7:12:200.
doi: 10.1186/1477-7819-12-200.

Relationship between hypoparathyroidism and the number of parathyroid glands preserved during thyroidectomy

Chang Myeon Song, Joo Hwan Jung, Yong Bae Ji, Hyun Jung Min, You Hern Ahn, Kyung Tae  1
Affiliations

Relationship between hypoparathyroidism and the number of parathyroid glands preserved during thyroidectomy

Chang Myeon Song et al. World J Surg Oncol. .

Abstract

Background: The relationship between the number of parathyroid glands preserved and hypoparathyroidism is not well understood. We sought to determine the number of parathyroid glands that need to be preserved to prevent hypoparathyroidism.

Methods: We analyzed 454 patients who underwent total thyroidectomy for papillary thyroid carcinoma. We analyzed the frequency of hypoparathyroidism according to the number of parathyroid glands preserved.

Results: Incidental parathyroidectomy occurred in 19.8% of the patients; one parathyroid gland in 17.6%, two in 1.5%, and three in 0.7%. Transient hypoparathyroidism was increased when incidental parathyroidectomy occurred (odds ratio 1.83, 95% confidence interval 1.04 to 3.23, P = 0.036) on multivariate regression analysis, but was not influenced by the actual number of parathyroid glands removed. There was no relationship between the number of parathyroid glands preserved and permanent hypoparathyroidism (P = 0.147).

Conclusions: Preservation of all parathyroid glands decreases transient hypoparathyroidism compared with when three or fewer glands are preserved, but does not affect permanent hypoparathyroidism. During total thyroidectomy, preserving at least one parathyroid gland with an intact blood supply appears to be sufficient to prevent permanent hypoparathyroidism when autotransplantation is not performed.

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Figures

Figure 1
Figure 1
The patient flow chart. Thirty-five patients who underwent parathyroid autotransplantation were excluded. Patients were grouped according to the number of parathyroid glands found in the surgical specimen on histological examination, and the rate of hypoparathyroidism was compared between the groups.
See this image and copyright information in PMC

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