PARATHYROID IDENTIFICATION AND PRESERVATION, WITH OR WITHOUT AUTOTRANSPLANTATION, AS A PREDICTOR OF HYPOCALCEMIC SYMPTOMS IN TOTAL THYROIDECTOMY

Abstract

Objective: To assess hypocalcemic symptoms following total thyroidectomy done with parathyroid preservation, with or without parathyroid autotransplanation.

Materials and Method: Total of 31 patients who underwent total thyroidectomy with or without neck dissection were included in this study. The number of parathyroids identified and preserved or auto-transplanted on sternocleidomastoid muscle was recorded intra-operatively. Postoperative serum iPTH measured on 1st POD and corrected serum calcium were measured on 1st, 3rd and 5th POD. Clinical hypocalcemia was assessed by history, Trousseau’s and Chovstek’s sign.

Results: Total of 31 patients underwent total thyroidectomy with or without neck dissection. Patients were divided into two groups – group A (parathyroid preservation and autotransplantation group) and group B (parathyroid preservation without autotransplantation group). There were five female and one male patient in group A, whereas there were 19 female and six male patients in group B. There was no statistically significant difference in terms of serum iPTH (p=0.594), corrected serum calcium on 1st POD (p=0.65), 3rd POD (p=0.347) and 5th POD (p=0.175) between two groups. There was no statistically significant difference in hypocalcemic symptoms between two groups (Pearson Chi-square test, p =0.363).

Conclusion: Effect of autotransplantation of parathyroid in total thyroidectomy on early post-operative hypocalcemia prevention was not significant in our study but needs further study with larger sample size to come to definitive conclusion.

Keywords: iPTH, Parathyroid Autotransplantation, Parathyroid Preservation, Total Thyroidectomy