title: Autotransplantation of Inferior Parathyroid glands during central neck dissection for papillary thyroid carcinoma: a retrospective cohort study.
abstract: BACKGROUND
  The management of inferior parathyroid glands during central neck dissection (CND) for papillary thyroid carcinoma (PTC) remains controversial. Most surgeons preserve inferior parathyroid glands in situ. Autotransplantation is not routinely performed unless devascularization or inadvertent parathyroidectomy occurs. This retrospective study aimed to compare the incidence of postoperative hypoparathyroidism and central neck lymph node (CNLN) recurrence in patients with PTC who underwent inferior parathyroid glands autotransplantation vs preservation in situ.
  
  
  METHODS
  This is a retrospective study which was conducted in a tertiary referral hospital. A total of 477 patients with PTC (pN1) who underwent total thyroidectomy (TT) and bilateral CND with/without lateral neck dissection were included. Patients' demographical characteristics, tumor stage, incidence of hypoparathyroidism, CNLN recurrence and the number of resected CNLN were analyzed.
  
  
  RESULTS
  Three hundred and twenty-one patients underwent inferior parathyroid glands autotransplantation (autotransplantation group). Inferior parathyroid glands were preserved in situ among 156 patients (preservation group). Permanent hypoparathyroidism rate was 0.9% (3/321) versus 3.8% (6/156) respectively (p = 0.028). Mean numbers of resected CNLN were 15 ± 3 (6-23) (autotransplantation group) versus 11 ± 3 (7-21) (preservation group) (p < 0.001). CNLN recurrence rate was 0.3% (1/321) versus 3.8% (6/156) respectively (p = 0.003).
  
  
  CONCLUSIONS
  Inferior parathyroid glands autotransplantation during CND of PTC (pN1) might reduce permanent hypoparathyroidism and CNLN recurrence. Further study enrolling more patients with long-term follow-up is needed to support this conclusion.
authors.affiliation: Department of Thyroid & Breast Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR. China.
authors.forename: Tao
authors.initials: T
authors.lastname: Wei
authors.affiliation: Department of Thyroid & Breast Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR. China.
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Endocrine Surgery, Endocrine & Metabolism Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Judy
authors.initials: J
authors.lastname: Jin
authors.affiliation: Department of Thyroid & Breast Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR. China.
authors.forename: Rui
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Thyroid & Breast Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR. China.
authors.forename: Yanping
authors.initials: Y
authors.lastname: Gong
authors.affiliation: Department of Thyroid & Breast Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR. China.
authors.forename: Zhenhong
authors.initials: Z
authors.lastname: Du
authors.affiliation: Department of Thyroid & Breast Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR. China.
authors.forename: Rixiang
authors.initials: R
authors.lastname: Gong
authors.affiliation: Department of Thyroid & Breast Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR. China. Electronic address: zjq-wkys@163.com.
authors.forename: Jingqiang
authors.initials: J
authors.lastname: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000601:surgery*; D002291:Carcinoma, Papillary; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007011:Hypoparathyroidism / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D015994:Incidence; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D037981:Neck Dissection / Q000379:methods*; D059351:Organ Sparing Treatments / Q000706:statistics & numerical data; D010280:Parathyroid Glands / Q000637:transplantation*; D016105:Parathyroidectomy / Q000009:adverse effects; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects; D014182:Transplantation, Autologous; D055815:Young Adult
keywords: Central neck dissection; Papillary thyroid carcinoma; Parathyroids autotransplantation