Selective parathyroid autotransplantation prevent permanent hypoparathyroidism after total thyroidectomy with central neck dissection

BackgroundThe 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 c...

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Main Authors: Haili Sun, Li Gao, Guizhou Xiao, Lei Xie, Yiyu Zhuang, Jianbiao Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1565581/full
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author Haili Sun
Li Gao
Guizhou Xiao
Lei Xie
Yiyu Zhuang
Jianbiao Wang
author_facet Haili Sun
Li Gao
Guizhou Xiao
Lei Xie
Yiyu Zhuang
Jianbiao Wang
author_sort Haili Sun
collection DOAJ
description BackgroundThe 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).MethodA 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).ResultThe 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.ConclusionSelective 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.
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spelling doaj-art-ef70f20c70364905af5eeb9f04f097d12025-08-20T03:15:03ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-04-011210.3389/fsurg.2025.15655811565581Selective parathyroid autotransplantation prevent permanent hypoparathyroidism after total thyroidectomy with central neck dissectionHaili Sun0Li Gao1Guizhou Xiao2Lei Xie3Yiyu Zhuang4Jianbiao Wang5Nursing Department, The Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Head and Neck Surgery, The Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Head and Neck Surgery, The Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Head and Neck Surgery, The Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaNursing Department, The Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Head and Neck Surgery, The Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaBackgroundThe 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).MethodA 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).ResultThe 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.ConclusionSelective 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.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1565581/fullparathyroid glandautotransplantationin situ preservationtransient hypoparathyroidismpermanent hypoparathyroidism
spellingShingle Haili Sun
Li Gao
Guizhou Xiao
Lei Xie
Yiyu Zhuang
Jianbiao Wang
Selective parathyroid autotransplantation prevent permanent hypoparathyroidism after total thyroidectomy with central neck dissection
Frontiers in Surgery
parathyroid gland
autotransplantation
in situ preservation
transient hypoparathyroidism
permanent hypoparathyroidism
title Selective parathyroid autotransplantation prevent permanent hypoparathyroidism after total thyroidectomy with central neck dissection
title_full Selective parathyroid autotransplantation prevent permanent hypoparathyroidism after total thyroidectomy with central neck dissection
title_fullStr Selective parathyroid autotransplantation prevent permanent hypoparathyroidism after total thyroidectomy with central neck dissection
title_full_unstemmed Selective parathyroid autotransplantation prevent permanent hypoparathyroidism after total thyroidectomy with central neck dissection
title_short Selective parathyroid autotransplantation prevent permanent hypoparathyroidism after total thyroidectomy with central neck dissection
title_sort selective parathyroid autotransplantation prevent permanent hypoparathyroidism after total thyroidectomy with central neck dissection
topic parathyroid gland
autotransplantation
in situ preservation
transient hypoparathyroidism
permanent hypoparathyroidism
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1565581/full
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