Evaluation of patients who have undergone unintentional parathyroidectomy following thyroidectomy: a retrospective cohort study

Abstract

Aim:We investigated the postoperative parathormone levels and the incidence of hypocalcemia in patients who had inadvertently underwent parathyroidectomy during thyroid surgery in this study. Material and Methods: We retrospectively evaluated a total of 142 patients who had undergone thyroidectomy between January 2011 and March 2017 from their charts. The demographic feature sand pathology diagnoses of the thyroidectomy patients were evaluated. The number of excised parathyroid glands in the pathology specimens and their location were determined. The PTH level was checked after surgery. Calcium was measured on the 2nd day. Results: The 142 patients consisted of 23 males (16.2%) and 119 females (83.8%). The mean age was 49.5 years. The surgery performed was bilateral total thyroidectomy in 131, bilateral subtotal thyroidectomy in 3, left total right subtotal thyroidectomy in 3, right total left subtotal thyroidectomy in 2, left thyroid lobectomy in 2, and complementary thyroidectomy in 1. Parathyroid tissue was found to have been excised during surgery in 35 patients, consisting of 33 females (94.2%) and 2 males (5.8%). The parathyroid tissue had been removed incidentally in 31 and not incidentally in 4. Conclusion:We found that some parathyroid glands had been inadvertently removed despite careful thyroid surgery.

Video‐assisted parathyroid gland mapping with autofocusing

“…The PTGs are variably located on the back of the thyroid gland, buried in the central neck compartment tissues and not easily distinguished from other adipose or connective tissues by the naked eye. Therefore, it is often damaged during tissue dissection or found in extracted specimens unintentionally . If the PTG is compromised, it leads to complications, such as hypoparathyroidism.…”

“…Some studies have shown that inadvertent parathyroidectomy is approximately 18% during thyroid surgery, while patients experience temporary hypocalcemia (28.9%‐30.7%) and permanent hypocalcemia (1.6%‐9.6%) after thyroid surgery .…”