Background and Objectives. Parathyroid failure is the most common symptom after thyroidectomy. To prevent it, a gland was\npreserved in situ or an ischemic one was autotransplanted. This study explored the relationship between in situ preservation of\nthe parathyroid gland and gland failure. Methods. Consecutive patients who underwent initial total thyroidectomy were enrolled\nretrospectively in a prospectively maintained database. Patients were divided into groups by parathyroid gland remaining in situ\nfraction (PGRIF) (PGRIF = number of in situ glands/(total number of identified glands âË?â?? number of glands in specimen).\nPatients were graded by tertiles and followed at least one year after surgery. Results. 559 patients were included. PGRIF is\nsignificantly inversely associated with transient hypoparathyroidism, protracted hypoparathyroidism, and postoperative\nhypocalcemia. PGRIF was identified as an independent risk factor for transient hypoparathyroidism, protracted\nhypoparathyroidism, and postoperative hypocalcemia (OR = 0 177, 0.190, and 0.330, resp.). Auto transplantation of parathyroid\ngland would not affect the calcium level in the long term. Conclusion. In situ preservation of parathyroid gland is crucial for\nparathyroid function. Less preserved is the independent risk factor for postoperative hypoparathyroidism and hypocalcemia,\nresulting in a worse function of parathyroid gland in the long term.
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