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TOTAL THYROIDECTOMY – DOES UNDERLYING PATHOLOGY EFFECT PARATHYROID AUTOTRANSPLANTATION AND RELATED COMPLICATIONS?
Author(s) -
Ebrahimi H.,
Lundgren C. I.,
Sidhu S. B.,
Sywak M. S.,
Edhouse P.,
Delbridge L. W.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04118_4.x
Subject(s) - hypocalcaemia , medicine , hypoparathyroidism , autotransplantation , graves' disease , thyroidectomy , incidence (geometry) , thyroid , surgery , parathyroid gland , retrospective cohort study , parathyroid hormone , transplantation , calcium , physics , optics
Background Total thyroidectomy (TT) is increasingly being accepted as the preferred surgical option for the treatment of a majority of benign and malignant thyroid conditions. Parathyroid autotransplantation is an accepted technique for retaining parathyroid function following TT. The present study aims to determine whether the underlying thyroid pathology has any effect on the number of parathyroid glands autotransplanted and subsequent complications. Methods A retrospective study of all TT cases performed by this unit in 2004–2005 was performed. The underlying pathology, number of parathyroid glands autotransplanted and incidence of temporary hypocalcaemia and permanent hypoparathyroidism were recorded. Results A total of 681 TT were analysed. Of these, 80 (11.7%) were for Graves’ disease and 601 (88.3%) were for other pathologies. For the Graves’ disease cases, 49 (61.3%) required 1 or less parathyroid glands to be autotransplanted and 31 (38.8%) required 2 or more. This is compared to 443 (73.7%) and 156 (26.0%) for non‐Graves’ disease cases (p = 0.023). There was also a significant difference (p = 0.025) in the incidence of temporary hypocalcaemia between Graves’, 10 (12.5%) and non‐Graves’ cases, 33 (5.5%). The incidence of permanent hypoparathyroidism was 1 (1.3%) and 5 (0.8%) for Graves’ and non‐Graves’ cases respectively (p = 0.529). Conclusion Total thyroidectomy for Graves’ disease does require the autotransplantation of significantly more parathyroid glands and increases the incidence of temporary hypocalcaemia post TT. It does not however significantly increase the incidence of permanent hypoparathyroidism.