The Association of Discolored Parathyroid Glands and Hypoparathyroidism Following Total Thyroidectomy

World Journal of Surgery
Brian Hung-Hin LangRita Y K Chang

Abstract

It remains uncertain whether a parathyroid gland (PG) that appears darkened or severely bruised but still has an attached vascular pedicle should be left in situ or taken out and auto-transplanted following total thyroidectomy. Our study aimed to examine the impact of discolored PGs (DPGs) on short- and long-term hypoparathyroidism. One hundred and three patients who underwent total thyroidectomy with 4 clearly identified PGs were analyzed. Location (superior/inferior) and color of each PG were recorded. Patients without DPG were grouped into I while those with 1-2 DPGs and ≥3 DPGs were grouped into II and III, respectively. Transient hypoparathyroidism meant adjusted Ca <2.00 mol/L 24 h after surgery and/or need for supplements. Protracted hypoparathyroidism meant a subnormal PTH at 4-6 weeks and/or supplements >6 weeks. Permanent hypoparathyroidism meant supplements ≥1 year. Relative to I, group III had greater adjusted Ca drop at postoperative 1-h (p = 0.012), 24-h (p < 0.001) and lower day-1 PTH (p = 0.015). Having ≥3 DPGs (OR 14.00, 95 % CI 1.575-124.474, p = 0.018) was an independent factor of transient hypoparathyroidism. However, permanent hypoparathyroidism rate was higher than in group I than II (p = 0.019). Eight pat...Continue Reading

References

Oct 20, 2010·Thyroid : Official Journal of the American Thyroid Association·Regina PrombergerMichael Hermann
Dec 15, 2010·World Journal of Surgery·James Kirkby-BottFausto Palazzo
Jan 10, 2014·The British Journal of Surgery·O EdafeS P Balasubramanian
May 27, 2014·Endocrine·Regina PrombergerMichael Hermann
Jan 22, 2015·The British Journal of Surgery·L Lorente-PochA Sitges-Serra

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Citations

Feb 13, 2018·Langenbeck's Archives of Surgery·Antonio Sitges-SerraJuan Sancho
Feb 16, 2018·European Surgery : ACA : Acta Chirurgica Austriaca·Elisabeth GschwandtnerMichael Hermann
Feb 6, 2021·Journal of Clinical Medicine·Antonio Sitges-Serra

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