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Abstract：
UNASSIGNED: Hypoparathyroidism is the most common complication for patients who undergo total thyroidectomy (TT) with bilateral central lymph node dissection (BCLND). The objective of this retrospective study was to investigate the relationship between parathyroid autotransplantation (PA) and postoperative hypoparathyroidism.
UNASSIGNED: Four hundred and sixty-five patients with papillary thyroid carcinoma (PTC) who underwent TT with BCLND (including prophylactic and therapeutic BCLND) by the same surgeon were enrolled in this retrospective study. They were divided into five groups based on the number of PAs. Group 0 was defined as no PA, while Group 1, 2, 3, and 4 were considered as 1, 2, 3, and 4 PAs during TT with BCLND, respectively.
UNASSIGNED: Transient and permanent hypoparathyroidism occurred in 83 (17.8%) and 2 (0.4%) patients who underwent TT and BCLND, respectively. The incidence of transient hypoparathyroidism increased gradually with an increase in the number of PAs. Compared with the previous group, Groups 2 and 3 had significantly more cases of transient hypoparathyroidism (p=0.03 and p=0.04, respectively). All cases of permanent hypoparathyroidism occurred in the patients without PA. Compared with Group 0, there were more removed central lymph nodes (RCLNs) in patients with one PA. Furthermore, Group 2 had more metastatic central lymph nodes(MCLNs) and RCLNs than Group 1.The number of PAs was the only identified risk factor for transient hypoparathyroidism after the multivariate logistic regression analysis. The median parathyroid hormone level recovered to the normal range within 1 month after surgery.
UNASSIGNED: With an increasing number of PAs, the possibility of transient hypoparathyroidism also increases in patients with PTC who undergo TT and BCLND. Considering the rapid recovery of transient hypoparathyroidism in 1 month, two PAs during TT and BCLND could be a good choice, leading to an increase in the central lymph node yield and no permanent hypoparathyroidism. However, this conclusion should be validated in future multicenter prospective studies.
UNASSIGNED: Four hundred and sixty-five patients with papillary thyroid carcinoma (PTC) who underwent TT with BCLND (including prophylactic and therapeutic BCLND) by the same surgeon were enrolled in this retrospective study. They were divided into five groups based on the number of PAs. Group 0 was defined as no PA, while Group 1, 2, 3, and 4 were considered as 1, 2, 3, and 4 PAs during TT with BCLND, respectively.
UNASSIGNED: Transient and permanent hypoparathyroidism occurred in 83 (17.8%) and 2 (0.4%) patients who underwent TT and BCLND, respectively. The incidence of transient hypoparathyroidism increased gradually with an increase in the number of PAs. Compared with the previous group, Groups 2 and 3 had significantly more cases of transient hypoparathyroidism (p=0.03 and p=0.04, respectively). All cases of permanent hypoparathyroidism occurred in the patients without PA. Compared with Group 0, there were more removed central lymph nodes (RCLNs) in patients with one PA. Furthermore, Group 2 had more metastatic central lymph nodes(MCLNs) and RCLNs than Group 1.The number of PAs was the only identified risk factor for transient hypoparathyroidism after the multivariate logistic regression analysis. The median parathyroid hormone level recovered to the normal range within 1 month after surgery.
UNASSIGNED: With an increasing number of PAs, the possibility of transient hypoparathyroidism also increases in patients with PTC who undergo TT and BCLND. Considering the rapid recovery of transient hypoparathyroidism in 1 month, two PAs during TT and BCLND could be a good choice, leading to an increase in the central lymph node yield and no permanent hypoparathyroidism. However, this conclusion should be validated in future multicenter prospective studies.
摘要：
■甲状旁腺功能减退是甲状腺全切除术（TT）伴双侧中央区淋巴结清扫（BCLND）患者最常见的并发症。这项回顾性研究的目的是探讨甲状旁腺自体移植（PA）与术后甲状旁腺功能减退之间的关系。
■本回顾性研究纳入了同一位外科医生接受BCLND（包括预防性和治疗性BCLND）TT的465例甲状腺乳头状癌（PTC）患者。根据PA的数量将他们分为五组。第0组定义为无PA，在使用BCLND进行TT期间，第1、2、3和4组被视为1、2、3和4个PA，分别。
■接受TT和BCLND的83例（17.8%）和2例（0.4%）患者发生了暂时性和永久性甲状旁腺功能减退症，分别。短暂性甲状旁腺功能减退症的发生率随着PAs数量的增加而逐渐增加。与前一组相比，第2组和第3组的短暂性甲状旁腺功能减退症病例明显增多（分别为p=0.03和p=0.04）。所有永久性甲状旁腺功能减退症均发生在无PA的患者中。与0组相比，一个PA患者的中央区淋巴结（RCLN）切除更多。此外，第2组比第1组具有更多的转移性中央区淋巴结(MCLNs)和RCLNs。多因素logistic回归分析后，PAs的数量是唯一确定的暂时性甲状旁腺功能减退的危险因素。中位甲状旁腺激素水平在术后1个月内恢复至正常范围。
■随着PA数量的增加，在接受TT和BCLND的PTC患者中,暂时性甲状旁腺功能减退的可能性也增加.考虑到暂时性甲状旁腺功能减退症在1个月内迅速恢复，TT和BCLND期间的两个PA可能是一个不错的选择，导致中央淋巴结产量增加，没有永久性甲状旁腺功能减退。然而,这一结论应在未来的多中心前瞻性研究中得到验证.
■本回顾性研究纳入了同一位外科医生接受BCLND（包括预防性和治疗性BCLND）TT的465例甲状腺乳头状癌（PTC）患者。根据PA的数量将他们分为五组。第0组定义为无PA，在使用BCLND进行TT期间，第1、2、3和4组被视为1、2、3和4个PA，分别。
■接受TT和BCLND的83例（17.8%）和2例（0.4%）患者发生了暂时性和永久性甲状旁腺功能减退症，分别。短暂性甲状旁腺功能减退症的发生率随着PAs数量的增加而逐渐增加。与前一组相比，第2组和第3组的短暂性甲状旁腺功能减退症病例明显增多（分别为p=0.03和p=0.04）。所有永久性甲状旁腺功能减退症均发生在无PA的患者中。与0组相比，一个PA患者的中央区淋巴结（RCLN）切除更多。此外，第2组比第1组具有更多的转移性中央区淋巴结(MCLNs)和RCLNs。多因素logistic回归分析后，PAs的数量是唯一确定的暂时性甲状旁腺功能减退的危险因素。中位甲状旁腺激素水平在术后1个月内恢复至正常范围。
■随着PA数量的增加，在接受TT和BCLND的PTC患者中,暂时性甲状旁腺功能减退的可能性也增加.考虑到暂时性甲状旁腺功能减退症在1个月内迅速恢复，TT和BCLND期间的两个PA可能是一个不错的选择，导致中央淋巴结产量增加，没有永久性甲状旁腺功能减退。然而,这一结论应在未来的多中心前瞻性研究中得到验证.
