Parathyroid autotransplantation for inadvertently resected or devascularized glands during total thyroidectomy: large retrospective cohort study.

Authors

Mingjie Jiang, Yongchao Yu, Zan Jiao, Tong Wu, Ke Jiang, Zulu Ye, Zhongyuan Yang, Weichao Chen, Ankui Yang

Published in

BJS open. Volume 10. Issue 4. Jul 03, 2026.

Abstract

Although recent guidelines recommend parathyroid autotransplantation for inadvertent excision of ischaemic glands, its benefit for the recovery of parathyroid function after total thyroidectomy remains uncertain.
This retrospective study analysed patients with normal parathyroid hormone (PTH) concentrations who underwent primary total thyroidectomy at Sun Yat-sen University Cancer Center between September 2013 and November 2024. Postoperative hypoparathyroidism and PTH trajectories were compared across three groups: autotransplantation, inadvertent parathyroid resection, and all glands preserved in situ. Long-term recovery was modelled using generalized additive mixed models (GAMM).
Of 7539 eligible patients, 441 (5.8%) underwent autotransplantation and 814 (10.8%) had inadvertent parathyroid resection. Higher proportions of parathyroid autotransplantation or inadvertent resection were observed among patients undergoing central neck dissection, particularly bilateral procedures. Postoperative (POD) 1 hypoparathyroidism (PTH < 15 pg/ml) occurred in 64.9% and 62.4% of patients in the autotransplantation and inadvertent resection groups, respectively, compared with 50.7% of patients with in situ gland preservation. At 1 month, hypoparathyroidism was present in 17.1% and 22.5% of patients in the autotransplantation and inadvertent resection groups, respectively, compared with 11.9% of patients with in situ gland preservation. Among patients with POD1 hypoparathyroidism, the recovery of parathyroid function at 1 month was similar in the autotransplantation and in situ preservation groups (∼72% and ∼74%, respectively), but lower in the group with inadvertent resection (∼62%). GAMMs showed poorest long-term recovery after inadvertent resection, whereas recovery in the autotransplantation group approached in situ preservation without clear superiority.
Parathyroid autotransplantation improved long-term recovery compared with inadvertent resection but did not outperform in situ preservation. These findings support autotransplantation for inadvertently resected parathyroid glands, but not for devascularized glands.

PMID:
42594360
Bibliographic data and abstract were imported from PubMed on 14 Aug 2026.

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