Thyroid Surgery 101: Less unnecessary thyroid surgery and less extent of surgery are keys to reducing damage to Parathyroid glands.
Lobe removal spares exposing the other two glands.
Thyroid 28 (7) 2018 p. 830-841
Orloff et al
ATA statement on Post op hyopparathyroidism.
Key Ways to avoid and treat parathyroid disease post op.
- Surgery done in a way to avoid removal or removing the blood supply of the parathyroid glands.Less totals and more lobectomies. Also avoid surgery on patients with benign disease with more careful screening of suspicious nodules with molecular markers.
- Autotransplant damaged glands or those with compromised blood supply.
- Treat at risk patient with calcium.
- Measure PTH/Calcium post op.
- Titrate calcium levels post op.
- Tell primary care about the worry of permanent hypoparathyroidism post op.
- Still need calcium by 6 months is a sign of permanent hypoparathyroidism.
- Recombinant human PTH analogues may be used.
- Avoiding parathyroid disease post op is easier than treated it long term.