Investigation of the effect of perioperative parathyroid autotransplantation in incidental parathyroidectomy cases on the development of postoperative hypocalcemia: a retrospective observational study.

Abstract

Purpose: One of the most common and significant complications following thyroid surgery is postoperative hypocalcemia due to postoperative hypoparathyroidism. This study aimed to observe the effect of parathyroid gland autotransplantation on postoperative hypocalcemia in cases of incidental parathyroidectomy in total thyroidectomy cases.

Methods: Patients who underwent bilateral total thyroidectomy surgery were retrospectively analyzed. Patients in the study population were divided into group A (no incidental parathyroidectomy), group B (incidental parathyroidectomy with no autotransplantation), and group C (incidental parathyroidectomy with autotransplantation). The patients' calcium levels on day 1, transient and permanent hypocalcemia times, time to return to normocalcemia, and surgery duration were examined.

Results: A total of 647 patients meeting the research criteria were included in the study. Group A consisted of 443 patients (68.5%), group B consisted of 176 patients (27.2%), and group C consisted of 28 patients (4.3%). The rate of incidental parathyroidectomy in the entire patient population was 31.5% (n = 204). Transient and permanent hypocalcemia rates in the entire patient population were 27.7% (n = 178) and 0.6% (n = 4), respectively. It was observed that the frequency of day 1 hypocalcemia was higher in group B than in group C among incidental parathyroidectomy groups (P = 0.005). Furthermore, group B had a significantly higher frequency of transient hypocalcemia compared to group C (P = 0.006). There was no significant difference in terms of permanent hypocalcemia.

Conclusion: This study showed that parathyroid gland autotransplantation reduces transient hypocalcemia in patients with 2 or fewer incidental parathyroids.