Analysis of the incidence and factors predictive of inadvertent parathyroidectomy during thyroid surgery

Hone, Robert; Tikka, Theofano; Kaleva, A; Hoey, Andrew W; Alexander, V; Balfour, Alistair; Nixon, Iain J.

doi:10.1017/s0022215116008136

Cited by 21 publications

(24 citation statements)

References 25 publications

(38 reference statements)

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“…The IP rate in our large cohort of patients was 11.3% which falls within the range of IP rates published previously (3.7-28.0%) (5,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Our study is the first study, to our knowledge, to investigate in depth the effect of the presence of LN to the incidence of IP.…”

Section: Discussionsupporting

confidence: 85%

“…A number of studies in the literature have published conflicting evidence on the factors that influence IP, a result of the small number of patients included, differences in practises between centres and variations in the population included in the studies (5,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). The purpose of this study was to evaluate the incidence of IP during thyroid operations in a large single centre case series during a period of 6 years and identify the risk factors involved.…”

Section: Introductionmentioning

confidence: 99%

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Inadvertent parathyroidectomy risk factors in 1,373 thyroidectomies—male gender and presence of lymphadenopathy, but not size of gland, independently increase the risk

et al. 2017

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Background: Inadvertent parathyroidectomy (IP) during thyroid operations is a recognised phenomenon.We evaluated the incidence of IP during thyroid operations in a large case-series and identified the risk factors involved. Results: One thousand three hundred and seventy-three patients were included in our study, 1,149 of them females (84%). IP rate was 11.3%. Univariate analysis showed that gender, thyroid gland weight, thyroid activity pre-operatively and type of operation are associated with IP. Logistic regression analysis has shown that female gender and the absence of LN in pathology were associated with less likelihood in developing IP than males and patients with presence of LN (P=0.051 and 0.014 respectively). IP occurs 2.14 and 2.28 times more often in TT and NTT when compared to the combination of TT and NTT (P=0.047 and 0.048 respectively). Conclusions:We present the largest single-centre case series on this topic, to our knowledge. The presence of LN, female gender and the type of operation are positively correlated to the IP rate. These factors could alert the surgeon to consider early calcium supplementation if the parathyroid glands (PG) have not been identified intraoperatively.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Inadvertent parathyroidectomy risk factors in 1,373 thyroidectomies—male gender and presence of lymphadenopathy, but not size of gland, independently increase the risk

et al. 2017

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“…Postoperative hypocalcemia may last for less than six months (transient) or more (permanent). Its reported incidence varies from center to center and range between 1.6% and 50%, with most of the reported cases being transient in nature (17)(18)(19)29). In our study, mean follow up time was 6.4±0.6 months and was similar in both group (p=0.81).…”

Section: Discussionmentioning

confidence: 99%

“…Increased rates of inadvertent parathyroidectomy (IP) after thyroid surgery have been reported by several studies, however, hypocalcemia or hypocalcemic symptoms weren't described in all patients (17)(18)(19). Risk factors for inadvertent parathyroid resection and iatrogenic injuries caused to the PG during neck surgeries include, neck dissections, re-operative thyroid surgeries, total thyroidectomy, hyperthyroidism and lack of surgical experience (3,4,(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

An Undesirable Post-Thyroidectomy Surprise for the Surgeon: Inadvertent Parathyroidectomy

Dural¹,

Akarsu²,

Çelik³

et al. 2018

atfm

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Objectives: This study aims to report the incidence of inadvertent parathyroid gland removal during thyroidectomies, as documented by pathology reports, and investigate its association with hypocalcemia. Materials and Methods: The patients who underwent thyroidectomy at our department between 2009 and 2013 were retrospectively reviewed. The patients who had standard total thyroidectomy were included in the study. Data on patient demographics, surgical reports, experience of surgeons, anatomical localization of excised parathyroid glands (PG) and laboratory results were evaluated. Patients were divided into two groups according to the presence or absence of an excised PG in the histopathology report (group P: presence of PG, and group T: absence of PG). Results: A total of 343 patients were included to study. Of these, 26 patients were in group P, and 317 in group T. Post-operative hypocalcemia was encountered in 37 patients. Hypocalcemia rates were similar between two groups (p=0.45). Surgical experience was found to decrease the rate of Inadvertent parathyroidectomy (IP) (p=0.04), however, it wasn't associated with post-operative hypocalcemia (p=0.72). Conclusion: IP is an undesirable finding that can be encountered by surgeons. Our findings showed that IP was found to be associated with surgical experience. However, these results were not associated with post-operative hypocalcemia.Amaç: Bu çalışmada tiroidektomi sırasında istenmeden çıkartılan ve patoloji raporlarında saptanan paratiroid bezlerinin insidansının saptanması ve hipokalsemi gelişimi ile ilişkisinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Kliniğimizde 2009 ile 2013 yılları arasında tiroidektomi uygulanan hastalar retrospektif olarak değerlendirildi. Standart total tiroidektomi yapılan olgular çalışmaya dahil edildi. Hastalara ait demografik veriler, ameliyat raporları, cerrahların deneyimi, eksize edilen paratiroid bezinin (PB) anatomik lokalizasyonu ve laboratuvar sonuçları değerlendirildi. Hastalar histopatoloji raporunda paratiroid bezi saptanan ve saptanmayanlar olmak üzere iki gruba ayrıldı. (grup P: PB saptananlar, and group T: PB saptanmayanlar). Bulgular: Çalışmaya toplam 343 hasta dahil edildi. Bunlar içerisinden, 26 hasta grup P'de, 317'si ise grup T'de yer aldı. Otuz yedi hastada postoperatif dönemde hipokalsemi saptandı. Hipokalsemi oranları her iki grupta benzerdi (p=0,45). Cerrahi deneyimin istemeden yapılan paratiroidektomi (İP) oranını düşürdüğü görüldü (p=0,04), ancak postoperatif hipokalsemi ile ilişkisi saptanmadı (p=0,72). Abstract Öz

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“…Hone et al report that concurrent neck dissection is an independent predictor of incidental parathyroidectomy and increases the risk by a factor of four. 9 …”

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confidence: 99%

Economics, epidemiology and outcomes

Hussain¹,

Fisher²,

Youngs³

et al. 2016

J. Laryngol. Otol.

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Analysis of the incidence and factors predictive of inadvertent parathyroidectomy during thyroid surgery

Abstract: The inadvertent parathyroidectomy rate was 16 per cent and concurrent neck dissection was identified as an independent predictor of inadvertent parathyroidectomy.

Cited by 21 publications

References 25 publications

Inadvertent parathyroidectomy risk factors in 1,373 thyroidectomies—male gender and presence of lymphadenopathy, but not size of gland, independently increase the risk

Inadvertent parathyroidectomy risk factors in 1,373 thyroidectomies—male gender and presence of lymphadenopathy, but not size of gland, independently increase the risk

An Undesirable Post-Thyroidectomy Surprise for the Surgeon: Inadvertent Parathyroidectomy

Economics, epidemiology and outcomes

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