Original CommunicationsRoutine parathyroid autotransplantation during thyroidectomy☆,☆☆
Section snippets
Materials and methods
From January 1998 to March 1999, there were 118 patients who underwent bilateral or completion thyroidectomies, who were at risk of postoperative hypocalcemia, and who underwent routine autotransplantation of at least 1 parathyroid gland during thyroidectomy by a single surgeon or surgical residents operating with supervision. Identification of all parathyroid glands was attempted to facilitate preservation, but excessive dissection to look for missing glands was avoided if at least 1
Results
There were 20 men and 98 women whose ages ranged from 16 to 82 years (median, 45 years). Operative procedures included total thyroidectomy (n = 49), near total (n = 10), completion total (n = 8), bilateral subtotal (n = 26), and ipsilateral total with contralateral subtotal (n = 25) thyroidectomies. Thyroid re-operations were performed in 11 patients (9.3%). The indications for operation included nodular hyperplasia (n = 54), Graves' disease (n = 31), papillary carcinoma (n = 26), follicular
Discussion
The practice of implanting parathyroid tissue has a long surgical tradition but the indication of PTHAT has recently been extended to radical head and neck operations, including total thyroidectomy.8 In fact, the biochemical function of parathyroid graft can be demonstrated after autotransplantation of normal parathyroid gland to the forearm23 and during long-term follow-up.17 In adopting a surgical technique using PTHAT, an operative strategy combining preservation of parathyroid in situ with
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Cited by (0)
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Reprint requests: Dr Chung Yau Lo, Division of Endocrine Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, Hong Kong, China.
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Surgery 2001;129:318-23.