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

World Journal of Surgical Oncology

Kyung Tae²  You Hern Ahn¹  Hyun Jung Min²  Yong Bae Ji²  Joo Hwan Jung²  Chang Myeon Song² 

[1] Department of Internal Medicine, College of Medicine, Hanyang University, 222 Wangsimniro, Seongdong-Gu, Seoul 133-792, South Korea;Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, 222 Wangsimniro, Seongdong-Gu, Seoul 133-792, South Korea

关键词: Hypocalcemia;    Hypoparathyroidism;    Thyroid cancer;    Parathyroid;    Thyroidectomy;   

Others  :  1148831
DOI  :  10.1186/1477-7819-12-200

 received in 2013-10-02, accepted in 2014-06-29,  发布年份 2014

【 摘 要 】

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.

【 授权许可】

   
2014 Song et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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