Routine parathyroid autotransplantation during total thyroidectomy: A procedure with predictable outcome

Objective: To compare parathyroid gland autotransplantation with parathyroid gland preservation in situ with respect to the preservation of parathyroid gland function in patients undergoing total thyroidectomy. Methods: The quasi-experimental study was performed from July 1998 to June 2009 at the Khyber Teaching Hospital, Peshawar, Pakistan. A total of 388 patients underwent total thyroidectomy for a variety of thyroid gland disorders. They were divided into two groups; 97 patients in Group A had parathyroid glands preserved in situ, while 291 patients in Group B had at least one parathyroid gland autotransplanted in ipsilateral sternocleidomastoid muscle. Both groups were followed for six months for the assessment of parathyroid function. Fisher s exact test was used for comparison between the two groups. Results: The mean age of Group A was 42.46±15.30 years, while in Group B it was 39.16±18.91 years. Overall male- to-female ratio was 1:3.5. In Group A, 3 (3.09%) patients developed permanent hypocalcaemia while in Group B only 1 (0.34%) patient developed permanent hypocalcaemia. Conclusion: Autotransplantation of at least one parathyroid gland after total thyroidectomy is a procedure with predictable outcome associated with minimal risk of permanent hypoparathyroidism.