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01.12.2014 | Research | Ausgabe 1/2014 Open Access

World Journal of Surgical Oncology 1/2014

Relationship between hypoparathyroidism and the number of parathyroid glands preserved during thyroidectomy

World Journal of Surgical Oncology > Ausgabe 1/2014
Chang Myeon Song, Joo Hwan Jung, Yong Bae Ji, Hyun Jung Min, You Hern Ahn, Kyung Tae
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-12-200) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests or financial ties to disclose.

Authors’ contribution

CMS and KT participated in the study design. CMS, JHJ, and YBJ participated in acquisition of data. HJM and YHA participated in interpretation of data and helped draft of manuscript. CMS and JHJ performed the literature review and data analysis. CMS and YBJ drafted the manuscript. YHA and KT revised the manuscript. All authors read and approved the final manuscript.



The relationship between the number of parathyroid glands preserved and hypoparathyroidism is not well understood. We sought to determine the number of parathyroid glands that need to be preserved to prevent hypoparathyroidism.


We analyzed 454 patients who underwent total thyroidectomy for papillary thyroid carcinoma. We analyzed the frequency of hypoparathyroidism according to the number of parathyroid glands preserved.


Incidental parathyroidectomy occurred in 19.8% of the patients; one parathyroid gland in 17.6%, two in 1.5%, and three in 0.7%. Transient hypoparathyroidism was increased when incidental parathyroidectomy occurred (odds ratio 1.83, 95% confidence interval 1.04 to 3.23, P = 0.036) on multivariate regression analysis, but was not influenced by the actual number of parathyroid glands removed. There was no relationship between the number of parathyroid glands preserved and permanent hypoparathyroidism (P = 0.147).


Preservation of all parathyroid glands decreases transient hypoparathyroidism compared with when three or fewer glands are preserved, but does not affect permanent hypoparathyroidism. During total thyroidectomy, preserving at least one parathyroid gland with an intact blood supply appears to be sufficient to prevent permanent hypoparathyroidism when autotransplantation is not performed.
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