Association of intraoperative mitoxantrone hydrochloride injection with incidental parathyroidectomy and parathyroid autotransplantation during gasless unilateral axillary endoscopic thyroidectomy: a propensity score-matched retrospective cohort study

Background

Preserving parathyroid glands during thyroidectomy remains challenging, particularly in remote-access procedures. Mitoxantrone hydrochloride injection (MHI) is a local lymphotropic tracer that may improve intraoperative discrimination of parathyroid glands during gasless unilateral axillary endoscopic thyroidectomy (GUAET), but evidence remains limited. We evaluated whether intraoperative MHI was associated with a lower rate of incidental parathyroidectomy (IP) during GUAET and described parathyroid autotransplantation (PAT) as a separate management outcome.