{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T02:54:32Z","timestamp":1780887272740,"version":"3.54.1"},"reference-count":37,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kaohsiung Medical University Gangshan Hospital","award":["KMGH-113R004"],"award-info":[{"award-number":["KMGH-113R004"]}]},{"name":"Kaohsiung Medical University Gangshan Hospital","award":["KMUH109-9M44"],"award-info":[{"award-number":["KMUH109-9M44"]}]},{"name":"Kaohsiung Medical University Gangshan Hospital","award":["KMUH110-0R51"],"award-info":[{"award-number":["KMUH110-0R51"]}]},{"name":"Kaohsiung Medical University Gangshan Hospital","award":["KMUH111-1R48"],"award-info":[{"award-number":["KMUH111-1R48"]}]},{"name":"Kaohsiung Medical University Gangshan Hospital","award":["KMUH112-2R51"],"award-info":[{"award-number":["KMUH112-2R51"]}]},{"name":"Kaohsiung Medical University Gangshan Hospital","award":["110-2314-B-037-120"],"award-info":[{"award-number":["110-2314-B-037-120"]}]},{"name":"Kaohsiung Medical University Gangshan Hospital","award":["111-2628-B-037-007"],"award-info":[{"award-number":["111-2628-B-037-007"]}]},{"name":"Kaohsiung Medical University Gangshan Hospital","award":["112-2314-B-037-034-"],"award-info":[{"award-number":["112-2314-B-037-034-"]}]},{"name":"Kaohsiung Medical University Gangshan Hospital","award":["113-2314-B-037-035-"],"award-info":[{"award-number":["113-2314-B-037-035-"]}]},{"name":"Kaohsiung Medical University Hospital, Kaohsiung Medical University","award":["KMGH-113R004"],"award-info":[{"award-number":["KMGH-113R004"]}]},{"name":"Kaohsiung Medical University Hospital, Kaohsiung Medical University","award":["KMUH109-9M44"],"award-info":[{"award-number":["KMUH109-9M44"]}]},{"name":"Kaohsiung Medical University Hospital, Kaohsiung Medical University","award":["KMUH110-0R51"],"award-info":[{"award-number":["KMUH110-0R51"]}]},{"name":"Kaohsiung Medical University Hospital, Kaohsiung Medical University","award":["KMUH111-1R48"],"award-info":[{"award-number":["KMUH111-1R48"]}]},{"name":"Kaohsiung Medical University Hospital, Kaohsiung Medical University","award":["KMUH112-2R51"],"award-info":[{"award-number":["KMUH112-2R51"]}]},{"name":"Kaohsiung Medical University Hospital, Kaohsiung Medical University","award":["110-2314-B-037-120"],"award-info":[{"award-number":["110-2314-B-037-120"]}]},{"name":"Kaohsiung Medical University Hospital, Kaohsiung Medical University","award":["111-2628-B-037-007"],"award-info":[{"award-number":["111-2628-B-037-007"]}]},{"name":"Kaohsiung Medical University Hospital, Kaohsiung Medical University","award":["112-2314-B-037-034-"],"award-info":[{"award-number":["112-2314-B-037-034-"]}]},{"name":"Kaohsiung Medical University Hospital, Kaohsiung Medical University","award":["113-2314-B-037-035-"],"award-info":[{"award-number":["113-2314-B-037-035-"]}]},{"name":"National Science and Technology Council, Taiwan","award":["KMGH-113R004"],"award-info":[{"award-number":["KMGH-113R004"]}]},{"name":"National Science and Technology Council, Taiwan","award":["KMUH109-9M44"],"award-info":[{"award-number":["KMUH109-9M44"]}]},{"name":"National Science and Technology Council, Taiwan","award":["KMUH110-0R51"],"award-info":[{"award-number":["KMUH110-0R51"]}]},{"name":"National Science and Technology Council, Taiwan","award":["KMUH111-1R48"],"award-info":[{"award-number":["KMUH111-1R48"]}]},{"name":"National Science and Technology Council, Taiwan","award":["KMUH112-2R51"],"award-info":[{"award-number":["KMUH112-2R51"]}]},{"name":"National Science and Technology Council, Taiwan","award":["110-2314-B-037-120"],"award-info":[{"award-number":["110-2314-B-037-120"]}]},{"name":"National Science and Technology Council, Taiwan","award":["111-2628-B-037-007"],"award-info":[{"award-number":["111-2628-B-037-007"]}]},{"name":"National Science and Technology Council, Taiwan","award":["112-2314-B-037-034-"],"award-info":[{"award-number":["112-2314-B-037-034-"]}]},{"name":"National Science and Technology Council, Taiwan","award":["113-2314-B-037-035-"],"award-info":[{"award-number":["113-2314-B-037-035-"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: In situ preservation is the primary strategy to preserve parathyroid gland (PG) function during thyroid surgery, while autotransplantation is used when inadvertent removal or devascularization occurs. Deciding on the optimal approach intraoperatively for exposed PGs remains challenging. This study evaluates intraoperative PG management strategies and long-term outcomes of PG function following total thyroidectomy. Methods: This retrospective study included 543 patients undergoing primary total thyroidectomy, excluding those with comorbid parathyroid disease. A stabbing test assessed the vascular supply of exposed PGs. PGs with fresh blood oozing after the test were preserved in situ; otherwise, they were autotransplanted. Intact parathyroid hormone (iPTH) and ionized calcium (iCa) were measured preoperatively and on postoperative day 1 (PO-1D), and during follow-up. Permanent hypoparathyroidism (PHPS) was defined as iPTH &lt; 15 pg\/mL, iCa &lt; 4.2 mg\/dL, or continued need for calcitriol or calcium supplementation after a postoperative period of 12 months (PO-12M). The PHPS rate was compared with the corresponding intraoperative PG status. Results: A total of 528 patients were enrolled in this study. At PO-1D, 434 patients (82.2%) had iPTH \u2265 15 pg\/mL, 65 (12.3%) had iPTH between 4 and 15 pg\/mL, and 29 (5.5%) had iPTH &lt; 4 pg\/mL. At PO-12M, 527 patients (99.81%) had iPTH \u2265 15 pg\/mL, 1 (0.19%) had iPTH between 4 and 15 pg\/mL, and none had iPTH &lt; 4 pg\/mL. Five patients (0.95%) were in PHPS after PO-12M. Among the 462 patients with at least one viable PG preserved in situ, the PHPS rate was 0.2%, compared to 6.1% (66 patients) for those without a viable PG preserved in situ (p &lt; 0.001). Conclusions: Permanent hypoparathyroidism is rare when at least one viable PG is preserved in situ during total thyroidectomy. The stabbing test is a simple, useful, and cost-effective method to assess the vascular supply of exposed PGs, providing surgeons with essential information for intraoperative PG management.<\/jats:p>","DOI":"10.3390\/diagnostics15050593","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T10:12:33Z","timestamp":1740737553000},"page":"593","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intraoperative Management of Parathyroid Glands and Long-Term Outcome of Parathyroid Function Following Total Thyroidectomy"],"prefix":"10.3390","volume":"15","author":[{"given":"Feng-Yu","family":"Chiang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, Kaohsiung 824, Taiwan"},{"name":"School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang Dae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Kosin University, Busan 49267, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0382-2072","authenticated-orcid":false,"given":"Kyung","family":"Tae","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwang Yoon","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Chun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, Kaohsiung 824, Taiwan"},{"name":"School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9841-9966","authenticated-orcid":false,"given":"Tzer-Zen","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, Kaohsiung 824, Taiwan"},{"name":"School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1052-5348","authenticated-orcid":false,"given":"Che-Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3547-9034","authenticated-orcid":false,"given":"Shih-Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chen","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, E-Da Cancer Hospital, I-Shou University, Kaohsiung 824, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5044-0325","authenticated-orcid":false,"given":"Tzu-Yen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Department of Otorhinolaryngology, School of Post-Baccalaureate Medicine and School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Gangshan Hospital, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 820, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s12020-019-02014-8","article-title":"Prevalence and risk factors for hypoparathyroidism following total thyroidectomy in Spain: A multicentric and nation-wide retrospective analysis","volume":"66","author":"Anda","year":"2019","journal-title":"Endocrine"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Abood, A., Ovesen, T., Rolighed, L., Triponez, F., and Vestergaard, P. 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