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

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. 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. 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. Autotransplantation of at least one parathyroid gland after total thyroidectomy is a procedure with predictable outcome associated with minimal risk of permanent hypoparathyroidism.