{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T05:55:53Z","timestamp":1763618153280,"version":"3.45.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of locally applied papaverine in preventing hypoparathyroidism after total thyroidectomy and its impact on parathyroid hormone (PTH) recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The First Affiliated Hospital of Zhengzhou University.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective cohort study involved 226 patients who underwent total thyroidectomy at the First Affiliated Hospital of Zhengzhou University from March 2023 to March 2025. The incidence of hypoparathyroidism on postoperative day 1 and the PTH recovery rate within 30 days afterward are compared between patients who received papaverine and those who did not. Data analysis uses the independent samples t-test, the Mann-Whitney U test, and the \u03c7\u00b2 test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients are divided into two groups: those who received intraoperative papaverine (n = 106) and a control group (n = 120). On postoperative day 1, hypoparathyroidism occurs in 40% of the papaverine group and 53% of the control group, respectively. Postoperative PTH recovery rates gradually increase over time, with significantly higher rates in the papaverine group compared to the control group on days 3, 5, and 30.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Applying papaverine directly during surgery effectively lowers the risk of early hypoparathyroidism after total thyroidectomy while promoting faster PTH recovery. This method is simple, easy to perform, and has a high safety profile. Future multicenter randomized controlled trials should be conducted to confirm long-term effectiveness and refine the dosing protocol.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1675722","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T05:12:42Z","timestamp":1763615562000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of topical papaverine on parathyroid function preservation after total thyroidectomy: a retrospective cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Jie","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binbin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binxin","family":"Hou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinqin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaonuo","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenhao","family":"Duan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shouhua","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26115173","article-title":"Thyroid cancer: epidemiology, classification, risk factors, diagnostic and prognostic markers, and current treatment strategies","volume":"26","author":"Forma","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11082299","article-title":"Risk factors for calcium-phosphate disorders after thyroid surgery","volume":"11","author":"S\u0119pek","year":"2023","journal-title":"Biomedicines"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e56585","DOI":"10.7759\/cureus.56585","article-title":"Incidence of post-thyroidectomy hypoparathyroidism and associated preoperative and intraoperative risk factors","volume":"16","author":"Al-Hakami","year":"2024","journal-title":"Cureus"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14215462","article-title":"Impact of lymph node dissection on postoperative complications of total thyroidectomy in patients with thyroid carcinoma","volume":"14","author":"Baud","year":"2022","journal-title":"Cancers"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2023.1203595","article-title":"Effect of intraoperative active exploration of parathyroid glands to reduce the incidence of postoperative hypoparathyroidism, and risk factors of hypoparathyroidism after total thyroidectomy: a single-centre study","volume":"10","author":"Zhou","year":"2023","journal-title":"Front Surg"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-024-03765-9","article-title":"Long-term complications of permanent hypoparathyroidism in adults: prevalence and associated factors","volume":"84","author":"Cherchir","year":"2024","journal-title":"Endocrine"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.758043","article-title":"Levothyroxine treatment and the risk of cardiac arrhythmias \u2013 focus on the patient submitted to thyroid surgery","volume":"12","author":"Gluvic","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000000351","article-title":"A commentary on \"Perioperative versus postoperative calcium and vitamin D supplementation to prevent symptomatic hypocalcemia after total thyroidectomy: a randomised placebo-controlled trial","volume":"109","author":"Zhao","year":"2023","journal-title":"Int J Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/s13193-020-01098-3","article-title":"Risk of hypocalcemia and the need to augment calcium supplementation after total thyroidectomy","volume":"13","author":"Verma","year":"2022","journal-title":"Indian J Surg Oncol"},{"key":"B10","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-031-31146-8_13","article-title":"Autotransplantation of the parathyroid glands in thyroidectomy: the role of autofluorescence and indocyanine green","volume-title":"Thyroid surgery","author":"Rosato","year":"2024"},{"key":"B11","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1007\/s11914-025-00904-7","article-title":"Calcium supplementation\u2014efficacy and safety","volume":"23","author":"Reid","year":"2025","journal-title":"Curr Osteoporos Rep"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2021.103161","article-title":"The anatomical basis for preserving the blood supply to the parathyroids during thyroid surgery, and a review of current technologic advances","volume":"43","author":"Shaari","year":"2022","journal-title":"Am J Otolaryngol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-024-10746-6","article-title":"Intraoperative detection of parathyroid glands using artificial intelligence: optimizing medical image training with data augmentation methods","volume":"38","author":"Lee","year":"2024","journal-title":"Surg Endosc"},{"key":"B14","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.otohns.2010.03.018","article-title":"Hemostasis in thyroid surgery: harmonic scalpel versus other techniques\u2014a meta-analysis","volume":"143","author":"Ecker","year":"2010","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines13051044","article-title":"Optimizing parathyroid preservation in thyroidectomy: the Burjeel protocol utilizing intraoperative indocyanine green near-infrared fluorescence imaging","volume":"13","author":"Hassan","year":"2025","journal-title":"Biomedicines"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s12640-021-00368-4","article-title":"Papaverine, a phosphodiesterase 10A inhibitor, ameliorates quinolinic acid-induced synaptotoxicity in human cortical neurons","volume":"39","author":"Bhat","year":"2021","journal-title":"Neurotox Res"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3390\/cells11213385","article-title":"The biological relevance of papaverine in cancer cells","volume":"11","author":"Gomes","year":"2022","journal-title":"Cells"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1590\/1413-785220243203e276513","article-title":"Randomized experimental study of topical vasodilators in microsurgery with cost analysis","volume":"32","author":"Rusig","year":"2024","journal-title":"Acta Ortop Bras"},{"key":"B19","first-page":"189","article-title":"Intraarterial vasodilator treatment for cerebral vasospasm after SAH: where are we and where do we go","volume-title":"Neuroradiology","author":"Diringer","year":"2023"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1007\/s10353-017-0481-1","article-title":"Effects of papaverine on healing of colonic anastomosis in rats","volume":"49","author":"Yilmaz","year":"2017","journal-title":"Eur Surg"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-020-01867-y","article-title":"Effects of active localization and vascular preservation of inferior parathyroid glands in central neck dissection for papillary thyroid carcinoma","volume":"18","author":"Hou","year":"2020","journal-title":"World J Surg Oncol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2607","article-title":"Sensitivity analysis in observational research: introducing the E-value","volume":"167","author":"VanderWeele","year":"2017","journal-title":"Ann Intern Med"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1128\/jvi.50.2.489-496.1984","article-title":"Effect of papaverine treatment on replication of measles virus in human neural and nonneural cells","volume":"50","author":"Miller","year":"1984","journal-title":"J Virol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e20240058","DOI":"10.21470\/1678-9741-2024-0058","article-title":"Optimal concentration of papaverine for the inhibition of internal thoracic artery vasospasm during coronary artery bypass graft surgery","volume":"40","author":"Tanaka-Totoribe","year":"2025","journal-title":"Braz J Cardiovasc Surg"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.21470\/1678-9741-2019-0126","article-title":"Effect of papaverine on left internal mammary artery flow: topical spraying versus perivascular injection method","volume":"35","author":"Gowda","year":"2020","journal-title":"Braz J Cardiovasc Surg"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1675722\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T05:12:42Z","timestamp":1763615562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1675722\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,20]]},"references-count":25,"alternative-id":["10.3389\/fendo.2025.1675722"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1675722","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,20]]},"article-number":"1675722"}}