Routine Parathyroid Autotransplantation?

👉Although most authors still favour the approach of selective (‘ready’) parathyroid autotransplantation, routine autotransplantation, a philosophical approach based on the understanding that while parathyroid autotransplantation is very effective, the viability of in situ vascularized parathyroids remains unpredictable with late ischaemia always a possibility.

👉The routine autotransplantation of at least one parathyroid gland during every total thyroidectomy, while unnecessary in most cases, provides insurance in cases where late ischaemia of the remaining glands actually occurs.

👉The parathyroid gland chosen for routine autotransplantation is either one determined to be non-viable on the basis of anatomical location or a failed knife-test, or else the least viable appearing of the remaining in situ glands.

👉Routine autotransplantion will be associated with an increase in the rate of temporary hypocalcaemia in the short term but has, in theory, the potential to reduce permanent hypoparathyroidism to zero.








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