Failure of fragmented parathyroid gland autotransplantation to prevent permanent hypoparathyroidism after total thyroidectomy

PURPOSE: Parathyroid autotransplantation during total thyroidectomy leads to higher rates of postoperative hypocalcaemia. It has been argued, however, that it prevents permanent hypoparathyroidism. The impact of autografted normal parathyroid gland fragments on long-term parathyroid status has not b...

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Autores: Lorente-Poch, Leyre, Sancho Insenser, Juan, Muñoz, Jose Luis, Gallego-Otaegui, Lander, Martínez-Ruiz, Carlos, Sitges-Serra, Antonio
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2017
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/33766
Acceso en línea:http://hdl.handle.net/10230/33766
http://dx.doi.org/10.1007/s00423-016-1548-3
Access Level:acceso abierto
Palabra clave:Paratiroïdes -- Malalties -- Tractament
Tiroide -- Cirurgia
Parathyroid autotransplantation
Permanent hypoparathyroidism
Postoperative hypocalcaemia
Total thyroidectomy
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spelling Failure of fragmented parathyroid gland autotransplantation to prevent permanent hypoparathyroidism after total thyroidectomyLorente-Poch, LeyreSancho Insenser, JuanMuñoz, Jose LuisGallego-Otaegui, LanderMartínez-Ruiz, CarlosSitges-Serra, AntonioParatiroïdes -- Malalties -- TractamentTiroide -- CirurgiaParathyroid autotransplantationPermanent hypoparathyroidismPostoperative hypocalcaemiaTotal thyroidectomyPURPOSE: Parathyroid autotransplantation during total thyroidectomy leads to higher rates of postoperative hypocalcaemia. It has been argued, however, that it prevents permanent hypoparathyroidism. The impact of autografted normal parathyroid gland fragments on long-term parathyroid status has not been assessed properly. To clarify this, the short- and long-term parathyroid function was assessed in patients with three glands remaining in situ after total thyroidectomy, in whom the fourth gland was either autotransplanted (Tx) or accidentally resected (AR). METHODS: Consecutive patients (n = 669) undergoing first-time total thyroidectomy were prospectively studied recording the number of parathyroid glands remaining in situ: PGRIS =4-(glands autografted + glands in the specimen). The study was focused on the subgroup of 186 patients with three parathyroid glands remaining in situ as a result of either accidental resection (AR, n = 76) or autotransplantation into the sternocleidomastoid muscle (Tx, n = 110). Prevalence of postoperative hypocalcaemia, protracted, and permanent hypoparathyroidism were compared between the two groups. Demographic, disease-related, laboratory, and surgical variables were recorded. All patients were followed for at least 1 year. RESULTS: Both groups were comparable in terms of disease and extent of surgery. Mean postoperative serum calcium was the same (AR: 1.97 ± 0.2 vs Tx: 1.97 ± 0.22 mmol/L). Rates of protracted (AR: 24% vs Tx: 25.5%) and permanent hypoparathyroidism (AR: 5.3% vs Tx: 7.3%) were similar in both groups. CONCLUSIONS: The prevalence of parathyroid failure syndromes after total thyroidectomy was similar whether a parathyroid gland was inadvertently excised or autotransplanted. Autotransplantation did not influence the permanent hypoparathyroidism rate.Springer20182017info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/33766http://dx.doi.org/10.1007/s00423-016-1548-3reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésLangenbeck's Archives of Surgery. 2017 Mar;402(2):281-7© Springer The final publication is available at Springer via http://dx.doi.org/10.1007/s00423-016-1548-3info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/337662026-06-12T07:21:37Z
dc.title.none.fl_str_mv Failure of fragmented parathyroid gland autotransplantation to prevent permanent hypoparathyroidism after total thyroidectomy
title Failure of fragmented parathyroid gland autotransplantation to prevent permanent hypoparathyroidism after total thyroidectomy
spellingShingle Failure of fragmented parathyroid gland autotransplantation to prevent permanent hypoparathyroidism after total thyroidectomy
Lorente-Poch, Leyre
Paratiroïdes -- Malalties -- Tractament
Tiroide -- Cirurgia
Parathyroid autotransplantation
Permanent hypoparathyroidism
Postoperative hypocalcaemia
Total thyroidectomy
title_short Failure of fragmented parathyroid gland autotransplantation to prevent permanent hypoparathyroidism after total thyroidectomy
title_full Failure of fragmented parathyroid gland autotransplantation to prevent permanent hypoparathyroidism after total thyroidectomy
title_fullStr Failure of fragmented parathyroid gland autotransplantation to prevent permanent hypoparathyroidism after total thyroidectomy
title_full_unstemmed Failure of fragmented parathyroid gland autotransplantation to prevent permanent hypoparathyroidism after total thyroidectomy
title_sort Failure of fragmented parathyroid gland autotransplantation to prevent permanent hypoparathyroidism after total thyroidectomy
dc.creator.none.fl_str_mv Lorente-Poch, Leyre
Sancho Insenser, Juan
Muñoz, Jose Luis
Gallego-Otaegui, Lander
Martínez-Ruiz, Carlos
Sitges-Serra, Antonio
author Lorente-Poch, Leyre
author_facet Lorente-Poch, Leyre
Sancho Insenser, Juan
Muñoz, Jose Luis
Gallego-Otaegui, Lander
Martínez-Ruiz, Carlos
Sitges-Serra, Antonio
author_role author
author2 Sancho Insenser, Juan
Muñoz, Jose Luis
Gallego-Otaegui, Lander
Martínez-Ruiz, Carlos
Sitges-Serra, Antonio
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Paratiroïdes -- Malalties -- Tractament
Tiroide -- Cirurgia
Parathyroid autotransplantation
Permanent hypoparathyroidism
Postoperative hypocalcaemia
Total thyroidectomy
topic Paratiroïdes -- Malalties -- Tractament
Tiroide -- Cirurgia
Parathyroid autotransplantation
Permanent hypoparathyroidism
Postoperative hypocalcaemia
Total thyroidectomy
description PURPOSE: Parathyroid autotransplantation during total thyroidectomy leads to higher rates of postoperative hypocalcaemia. It has been argued, however, that it prevents permanent hypoparathyroidism. The impact of autografted normal parathyroid gland fragments on long-term parathyroid status has not been assessed properly. To clarify this, the short- and long-term parathyroid function was assessed in patients with three glands remaining in situ after total thyroidectomy, in whom the fourth gland was either autotransplanted (Tx) or accidentally resected (AR). METHODS: Consecutive patients (n = 669) undergoing first-time total thyroidectomy were prospectively studied recording the number of parathyroid glands remaining in situ: PGRIS =4-(glands autografted + glands in the specimen). The study was focused on the subgroup of 186 patients with three parathyroid glands remaining in situ as a result of either accidental resection (AR, n = 76) or autotransplantation into the sternocleidomastoid muscle (Tx, n = 110). Prevalence of postoperative hypocalcaemia, protracted, and permanent hypoparathyroidism were compared between the two groups. Demographic, disease-related, laboratory, and surgical variables were recorded. All patients were followed for at least 1 year. RESULTS: Both groups were comparable in terms of disease and extent of surgery. Mean postoperative serum calcium was the same (AR: 1.97 ± 0.2 vs Tx: 1.97 ± 0.22 mmol/L). Rates of protracted (AR: 24% vs Tx: 25.5%) and permanent hypoparathyroidism (AR: 5.3% vs Tx: 7.3%) were similar in both groups. CONCLUSIONS: The prevalence of parathyroid failure syndromes after total thyroidectomy was similar whether a parathyroid gland was inadvertently excised or autotransplanted. Autotransplantation did not influence the permanent hypoparathyroidism rate.
publishDate 2017
dc.date.none.fl_str_mv 2017
2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/33766
http://dx.doi.org/10.1007/s00423-016-1548-3
url http://hdl.handle.net/10230/33766
http://dx.doi.org/10.1007/s00423-016-1548-3
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Langenbeck's Archives of Surgery. 2017 Mar;402(2):281-7
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Springer
publisher.none.fl_str_mv Springer
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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