In Situ Preservation Versus Auto transplantation of Parathyroid Gland After Total Thyroidectomy According to New Classification of Parathyroid Gland

Background Following total thyroidectomy, hypocalcaemia is a frequent side effect. It is crucial to prevent these issues by conserving the parathyroid glands, but they may get malnourished or inadvertently removed, even with all the care and attention given. The best method for preserving the gland’s function in this situation is autotransplantation. Objective Using carbon nanoparticles for localisation, the effects of autotransplantation and in situ preservation of a parathyroid gland on post-operative hypocalcemia and the recovery of parathyroid function following total thyroidectomy are compared using new classification of parathyroid gland. Patients and Methods El-demerdash Hospital’s ethics committee approved our prospective study (from September 2020 to July 2024) at Ain Shams University. Informed consent was taken. After the parathyroid glands were located using carbon nanoparticles at El-demerdash Hospital and Nasser Institute Hospital, 100 patients were prepared for total thyroidectomy divided into two groups, A (autotransplantation) and B (In situ preservation) according to parathyroid gland classification. Results Thirty eight individuals (38%) had temporary hypoparathyroidism, but no permanent hypoparathyroidism was found. Ten patients (20.0%) in group B and twenty-eight (56.0%) in group A had temporary hypoparathyroidism. A variety of preoperative parameters were assessed. Diabetes, hyperthyroidism, older age, female gender, and the number of parathyroid glands found intra- operatively are found to be risk factors for hypocalcemia, so a preventative calcium and vitamin D program could reduce the likelihood of temporary hypoparathyroidism. Conclusion Together with the usage of carbon nanoparticles, it is reasonable to conclude that in situ preservation or autotransplantation will further retain parathyroid function under the new categorisation. Taking into account pre-operative risk factors for post-operative hypoparathyroidism, combination preservation with autotransplantation of parathyroid glands is thought to be a more effective strategy than comparative study for reducing post-operative permanent hypoparathyroidism after thyroid surgery.