{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:47:36Z","timestamp":1787928456496,"version":"build-2784847793"},"reference-count":15,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,2,23]],"date-time":"2016-02-23T00:00:00Z","timestamp":1456185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,2,23]],"date-time":"2016-02-23T00:00:00Z","timestamp":1456185600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>\nIt remains uncertain whether a parathyroid gland (PG) that appears darkened or severely bruised but still has an attached vascular pedicle should be left in situ or taken out and auto\u2010transplanted following total thyroidectomy. Our study aimed to examine the impact of discolored PGs (DPGs) on short\u2010 and long\u2010term hypoparathyroidism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred and three patients who underwent total thyroidectomy with 4 clearly identified PGs were analyzed. Location (superior\/inferior) and color of each PG were recorded. Patients without DPG were grouped into I while those with 1\u20132 DPGs and \u22653 DPGs were grouped into II and III, respectively. Transient hypoparathyroidism meant adjusted Ca &lt;2.00\u00a0mol\/L 24 h after surgery and\/or need for supplements. Protracted hypoparathyroidism meant a subnormal PTH at 4\u20136 weeks and\/or supplements &gt;6 weeks. Permanent hypoparathyroidism meant supplements \u22651 year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Relative to I, group III had greater adjusted Ca drop at postoperative 1\u2010h (<jats:italic>p<\/jats:italic> = 0.012), 24\u2010h (<jats:italic>p<\/jats:italic> &lt; 0.001) and lower day\u20101\u00a0PTH (<jats:italic>p<\/jats:italic> = 0.015). Having \u22653 DPGs (OR 14.00, 95 % CI 1.575\u2013124.474, <jats:italic>p<\/jats:italic> = 0.018) was an independent factor of transient hypoparathyroidism. However, permanent hypoparathyroidism rate was higher than in group I than II (<jats:italic>p<\/jats:italic> = 0.019). Eight patients (25.8 %) in group I had undetectable day\u20101\u00a0PTH, while none in group III had undetectable day\u20101\u00a0PTH. Graves\u2019 disease\/toxic goiter (OR 15.166, 95 % CI 2.594\u201388.661, <jats:italic>p<\/jats:italic> = 0.003) and excised gland weight (OR 1.028, 95 % CI 1.010\u20131.046, <jats:italic>p<\/jats:italic> = 0.003) were independent factors of \u22653 DPGs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PG discoloration is associated with transient hypoparathyroidism while normal colored PG with seemingly adequate blood supply does not always imply functionally normal gland. These findings highlights the need for a real\u2010time intraoperative method to assess PG viability.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-016-3462-9","type":"journal-article","created":{"date-parts":[[2016,2,23]],"date-time":"2016-02-23T18:41:47Z","timestamp":1456252907000},"page":"1611-1617","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["The Association of Discolored Parathyroid Glands and Hypoparathyroidism Following Total Thyroidectomy"],"prefix":"10.1002","volume":"40","author":[{"given":"Brian Hung\u2010Hin","family":"Lang","sequence":"first","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong SAR China"},{"name":"Division of Endocrine Surgery, Department of Surgery Queen Mary Hospital 102 Pokfulam Road Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane T. Y.","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix Che\u2010Lok","family":"Chow","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai Pun","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita Y. K.","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,2,23]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9384"},{"issue":"1","key":"e_1_2_6_3_2","first-page":"82","article-title":"Defining the syndromes of parathyroid failure after total thyroidectomy","volume":"4","author":"Lorente\u2010Poch L","year":"2015","journal-title":"Gland Surg"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010011\u20101236\u2010y"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21175"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010015\u20103070\u20100"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2003.61"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9676"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097\u20100347(199908)21:5<442::AID\u2010HED10>3.0.CO;2\u2010Z"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0157"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12020\u2010014\u20100300\u20104"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010012\u20101561\u20109"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010013\u20102195\u20102"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2008.01.032"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010010\u20100872\u2010y"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010009\u20100377\u20108"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-016-3462-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-016-3462-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-016-3462-9","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T15:43:00Z","timestamp":1703605380000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-016-3462-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,23]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,7]]}},"alternative-id":["10.1007\/s00268-016-3462-9"],"URL":"https:\/\/doi.org\/10.1007\/s00268-016-3462-9","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,23]]}}}