Parathyroid Autotransplantation During Thyroid Surgery: A Novel Technique Using a Cell Culture Nutrient Solution

Famà, Fausto; Cicciù, Marco; Polito, Francesca; Gioffré-Florio, Maria; Piquard, Arnaud; Saint‐Marc, Olivier; Sindoni, Alessandro

doi:10.1007/s00268-016-3754-0

Cited by 13 publications

(15 citation statements)

References 74 publications

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“…There were 17 studies[10, 16, 20, 21, 27–31, 37, 39–41, 43, 44, 46, 48] that explored the relationship between PGA and the risk of postoperative hypoparathyroidism. Among them, 3 studies[10, 44, 46] used two different evaluation indexes. Significant heterogeneity was detected (I 2 = 79.3%, p<0.001).…”

Section: Resultsmentioning

confidence: 99%

“…The result that is presented in Fig 4A combines the RRs for the risk of permanent hypoparathyroidism. Nineteen studies[10, 16, 19–21, 24, 28–31, 39, 41–48] were used to generate the result, of which 3 studies[10, 44, 46] used two evaluation indexes. PGA was not associated with the risk of permanent hypoparathyroidism (RR = 0.95, 95% CI: 0.62–1.45, p = 0.801, Fig 4A), and substantial heterogeneity was observed (I 2 = 62.0%, p<0.001, Fig 4A).…”

Section: Resultsmentioning

confidence: 99%

“…PGA was first performed in humans by Lahey in 1926[49] and has become the most common method to preserve the function of the parathyroid gland, which cannot be preserved at its site[16, 41, 46]. In recent years, some surgeons have suggested that PGA should be routinely performed during total thyroidectomy[22–24].…”

Section: Discussionmentioning

confidence: 99%

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The effectiveness of parathyroid gland autotransplantation in preserving parathyroid function during thyroid surgery for thyroid neoplasms: A meta-analysis

Wang¹,

Zhu²,

Liu³

et al. 2019

PLoS ONE

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Objective We conducted this meta-analysis to assess the effectiveness of parathyroid gland autotransplantation in preserving parathyroid function during thyroid surgery for thyroid neoplasms. Methods We conducted a search by using PubMed, Embase, and the Cochrane Library electronic databases for studies that were published up to January 2019. The reference lists of the retrieved articles were also reviewed. Two authors independently assessed the methodological quality and extracted the data. A random-effects model was used to calculate the overall combined risk estimates. Publication bias was evaluated with a funnel plot using Egger’s and Begg’s tests. Results A total of 25 independent studies involving 10,531 participants were included in the meta-analysis. Compared with patients who did not undergo parathyroid gland autotransplantation, the overall pooled relative risks for patients who underwent parathyroid gland autotransplantation were 1.75 (95% CI: 1.51–2.02, p<0.001) for postoperative hypoparathyroidism, 1.72 (95% CI: 1.45–2.05, p<0.001) for protracted hypoparathyroidism, 1.06 (95% CI: 0.44–2.58, p = 0.894) and 0.71 (95% CI: 0.22–2.29, p = 0.561) for biochemical hypoparathyroidism and biochemical hypocalcemia at 6 months postoperatively, respectively, and 1.89 (95% CI: 1.33–2.69, p<0.001) and 0.22 (95% CI: 0.09–0.52, p = 0.001) for biochemical hypoparathyroidism and biochemical hypocalcemia at 12 months postoperatively, respectively. The pooled relative risks for patients who underwent one parathyroid gland autotransplantation and patients who underwent two or more parathyroid gland autotransplantations were 1.71 (95% CI: 1.25–2.35, p = 0.001) and 2.22 (95% CI: 1.43–3.45, p<0.001) for postoperative hypoparathyroidism, 1.09 (95% CI: 0.59–2.01, p = 0.781) and 0.55 (95% CI: 0.16–1.87, p = 0.341) for hypoparathyroidism at 6 months postoperatively compared with those of patients who did not undergo parathyroid gland autotransplantation. Conclusions Parathyroid gland autotransplantation is significantly associated with increased risk of postoperative and protracted hypoparathyroidism, and the number of autoplastic parathyroid glands is positively correlated with the incidence of postoperative hypoparathyroidism.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The effectiveness of parathyroid gland autotransplantation in preserving parathyroid function during thyroid surgery for thyroid neoplasms: A meta-analysis

Wang¹,

Zhu²,

Liu³

et al. 2019

PLoS ONE

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“…On the other hand, total thyroidectomy may present complications, such as hypoparathyroidism (often transient) (85) and recurrent laryngeal nerve injury (84), which occurs in 6% and 1% of patients, respectively (84). However, reoperation after partial thyroidectomy can be needed in cases with multifocal thyroid cancer or for radioactive iodine ablation.…”

Section: Discussionmentioning

confidence: 99%

Preoperatively undiagnosed papillary thyroid carcinoma in patients thyroidectomized for benign multinodular goiter

Famà¹,

Sindoni²,

Cicciù³

et al. 2018

Archives of Endocrinology and Metabolism

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Objective: Incidental thyroid cancers (ITCs) are often microcarcinomas; among them, the most frequent histotype is the papillary one. The purpose of this study was to evaluate the rate of papillary thyroid cancer (PTC) in patients thyroidectomized for benign multinodular goiter. Subject and methods: We retrospectively evaluated the histological incidence of PTC in 207 consecutive patients who, in a 1-year period, underwent thyroidectomy for benign multinodular goiter. All patients came from an iodine-deficient area (Orleans, France) with three nuclear power stations located in the neighboring areas of the county town. Results: Overall, 25 thyroids (12.1%) harbored 37 PTC, of which 31 were microcarcinomas. In these 25 PTC patients, mean age was 55 ± 10 years (range 30-75), female:male ratio 20:5 (4:1). In 10 patients (40% of 25 and 4.8% of 207), PTCs were bilateral, and in 7 (2 with microPTCs) the thyroid capsule was infiltrated. These 7 patients underwent central and lateral cervical lymph node dissections, which revealed lymph node metastases in one and two cases, respectively. Radioiodine treatment was performed in 7 cases. Neither mortality nor transient and permanent nerve injuries were observed. Four (16%) transient hypocalcaemias occurred as early complications. At last follow-up visit (mean length of follow-up 17.2 ± 3.4 months), all patients were doing well and free of any clinical local recurrence or distant metastases. Conclusion: With a 12% risk that multinodular goiter harbors preoperatively unsuspected PTCs, which can have already infiltrated the capsule and that can be accompanied by PTC foci contralaterally, an adequate surgical approach has to be considered. Arch Endocrinol Metab. 2018;62(2):139-48

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“…1,2 Among the complications of thyroid surgery, postoperative hypoparathyroidism was the most common. 3,4 The incidence of transient hypoparathyroidism ranged from 10.8% to 64.4%, and the incidence of permanent hypoparathyroidism varied from 0 to 31.1% across different researches. [5][6][7][8] Hypoparathyroidism was the consequence of the reduction of the functional parathyroid parenchyma for mechanical or thermal trauma, devascularization, and inadvertent resection.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Parathyroid Gland Autotransplantation on Hypoparathyroidism After Thyroid Surgery for Papillary Thyroid Carcinoma

Wang

Zhu

Yao

et al. 2021

CMAR

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There are some controversies over the relationship between parathyroid gland autotransplantation and permanent hypoparathyroidism. This study aimed to explore the relationship between parathyroid gland autotransplantation and postoperative hypoparathyroidism. Patients and Methods: We performed a retrospective analysis of patients who underwent initial thyroid surgery for papillary thyroid carcinoma from January 2014 to December 2018. Patients were divided into 4 groups according to the number of autotransplanted parathyroid glands (group 1: 0 autotransplanted parathyroid gland, group 2: 1 autotransplanted parathyroid gland, group 3: 2 autotransplanted parathyroid glands, group 4: 3 autotransplanted parathyroid glands). Clinical data were analyzed among the four groups. Results: The more parathyroid glands were transplanted, the higher the incidence of immediate hypoparathyroidism was (group 1: 32.9%, group 2: 52.9%, group 3: 65.8%, group 4: 82.4%; P group 1 vs group 2 < 0.001, P group 2 vs group 3 = 0.012, P group 3 vs group 4 = 0.17). Parathyroid gland autotransplantation did not affect the incidence of permanent hypoparathyroidism (group 1: 1.4%, group 2: 1.3%, group 3: 0.9%, group 4: 0%; P group 1 vs group 2 > 0.99, P group 2 vs group 3 > 0.99, P group 3 vs group 4 > 0.99). Conclusion:The number of autotransplanted parathyroid glands was positively associated with the incidence of postoperative immediate hypoparathyroidism. Parathyroid gland autotransplantation was not associated with permanent hypoparathyroidism.

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Parathyroid Autotransplantation During Thyroid Surgery: A Novel Technique Using a Cell Culture Nutrient Solution

Abstract: We recommend the routine parathyroid autotransplantation, when a vascular damage is certain or suspected, in order to reduce the rate of permanent hypoparathyroidism, using a cell culture nutrient solution before gland transplantation.

Cited by 13 publications

References 74 publications

The effectiveness of parathyroid gland autotransplantation in preserving parathyroid function during thyroid surgery for thyroid neoplasms: A meta-analysis

The effectiveness of parathyroid gland autotransplantation in preserving parathyroid function during thyroid surgery for thyroid neoplasms: A meta-analysis

Preoperatively undiagnosed papillary thyroid carcinoma in patients thyroidectomized for benign multinodular goiter

The Effect of Parathyroid Gland Autotransplantation on Hypoparathyroidism After Thyroid Surgery for Papillary Thyroid Carcinoma

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