Assessment between hypoparathyroidism and the number of parathyroid glands preserved during thyroidectomy: a record based study


  • Srujan Kumar Bellapu Department of General Surgery, Malla Reddy Institute of Medical Sciences, Suraram, Quthubullapur, Hyderabad, India



Hypoparathyroidism, Thyroidectomy, Parathyroid, Thyroid carcinoma, Hypocalcemia


Background: Hypoparathyroidism is a major complication of thyroidectomy. The association between the number of parathyroid glands preserved and hypoparathyroidism is not well understood. The objectives of the study were to evaluate the clinical characteristics and the frequency of hypoparathyroidism during thyroidectomy, and to determine the minimum number of parathyroid glands that need to be preserved to prevent hypoparathyroidism.

Methods: A retrospective study was conducted in Department of Surgery in Tertiary care hospital from January 2016 to December 2017. Around 250 patients who underwent total thyroidectomy for papillary thyroid carcinoma were analysed. We evaluated the frequency of hypoparathyroidism according to the number of parathyroid glands preserved.

Results: Incidental parathyroidectomy occurred in 20% of the patients; one parathyroid gland in 16%, two in 1.5%, and three in 0.9%. Transient hypoparathyroidism was increased when incidental parathyroidectomy occurred (odds ratio 1.63, 95% confidence interval 1.07 to 3.13, p=0.03). There was no significant relationship between the number of parathyroid glands preserved and permanent hypoparathyroidism (p=0.16).

Conclusions: Conservation of all parathyroid glands decreases transient hypoparathyroidism equated with when three or fewer glands are preserved but does not affect permanent hypoparathyroidism.


Palazzo FF, Sywak MS, Sidhu SB, Barraclough BH, Delbridge LW. Parathyroid autotransplantation during total thyroidectomy - does the number of glands transplanted affect outcome? World J Surg. 2005;29:629-31.

See AC, Soo KC. Hypocalcaemia following thyroidectomy for thyrotoxicosis. Br J Surg. 1997;84:95-7.

Lo CY. Parathyroid autotransplantation during thyroidectomy. ANZ J Surg. 2002;72:902-7.

Cavicchi O, Piccin O, Caliceti U, Decataldis A, Pasquali R, Ceroni A. Transient hypoparathyroidism following thyroidectomy: a prospective study and multivariate analysis of 604 consecutive patients. Otolaryngol Head Neck Surg. 2007;137:654-8.

Sasson AR, Pingpank JF Jr, Wetherington RW, Hanlon AL, Ridge JA. Incidental parathyroidectomy during thyroid surgery does not cause transient symptomatic hypocalcemia. Arch Otolaryngol Head Neck Surg. 2001;127:304-8.

Thomusch O, Machens A, Sekulla C, Ukkat J, Brauckhoff M, Dralle H. The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surg. 2003;133:180-5.

Almquist M, Hallgrimsson P, Nordenström E, Bergenfelz A. Prediction of permanent hypoparathyroidism after total thyroidectomy. World J Surg. 2014;38(10):2613-20.

Sidhic KA, Hisham Y, Nabeel TP, Abid KPA. The number of parathyroid glands preserved during thyroidectomy and relationship between hypoparathyroidism. Int Surg J. 2017;4:2898-902.

Song CM, Jung JH, Ji YB, Min HJ, Ahn YH, Tae K. Relationship between hypoparathyroidism and the number of parathyroid glands preserved during thyroidectomy. World J Surgical Oncol. 2014;12:200.

Grodski S, Serpell J. Evidence for the role of perioperative PTH measurement after total thyroidectomy as a predictor of hypocalcemia. World J Surg. 2008;32:1367-73.






Original Research Articles