Complications of Surgery of the Thyroid and Parathyroid Glands

Use of prophylactic oral calcium after total thyroidectomy: a prospective study

“…A significant difference in calcium measurement was observed between the two groups 180 days after surgery; of nine patients with hypocalcemia (19.2%), eight belonged to Group I and one to Group II (p = 0.0409). The incidence of permanent hypocalcemia (14.9%) was consistent with that in the literature (17%) (1). Other measurements (preoperative [PO] 7, PO90) showed no statistical differences between the study groups, with rates of hypocalcemia of 12.8% before surgery, 36.2% at 7 days after surgery, and 31.9% at 90 days after the procedure, as reported in Table 2.…”

“…The role of a meticulous surgical technique is well established in the literature, including the dissection of the superior and recurrent laryngeal nerves, careful dissection of the parathyroid glands, and ligation of the peripheral thyroid arteries as the main preventive measures against postoperative complications such as hypoparathyroidism and associated symptoms (1,7). Other causes may contribute to postoperative hypocalcemia, such as surgery extension, surgeon's experience, resection of one or more of the parathyroid glands, glandular lesions caused by suction in the operatory field and hemodilution (2,(8)(9)(10)(11), central compartment neck dissection, and reoperations.…”

“…In a classical description of the normal parathyroid glands, they are described as varying between one and six in number (a study by Hojaij has described the presence of four glands in 78.56% of 56 patients) (5,12) and as having a kidney-like shape, location in the posterior aspect of the thyroid gland, measurement of 3-8 mm and weight of 15-30 mg, yellow-brownish color, and irrigation by delicate branches of the inferior thyroid artery (1,5,13). Considerable anatomic variants of these glands may be found, and in 1998, Hojaij (5) reported the finding of mediastinal, intrathyroidal, and subcapsular parathyroids in 21.4%, 5.4%, and 14.3% of the cases, respectively.…”

An applied anatomical study on the recurrent laryngeal nerve and inferior thyroid artery

“…Bilateral loss of RLN function may be life-threatening [9]. Therefore, preventing nerve damage is currently standard practice in operations on the thyroid gland [13].…”

“…In view of this condition, surgeons and anatomists for more than a century have explored various procedures and employed many techniques to protect the RLN from injury during thyroid surgery [15]. However, cases of injury to the RLN still occur until now [1,5,9,11,18], their cause being the inexperience of the surgeon in some cases, but insufficient knowledge of the anatomic basis on the RLN is the cause in the majority of cases [6]. The aim of the present study was to assess the anatomical basis of the RLN and its relationship with the inferior thyroid artery to provide detailed information for application in thyroid surgery.…”