Incidence, Risk Factors, and Clinical Outcomes of Incidental Parathyroidectomy During Thyroid Surgery

Applewhite, Megan K.; White, Michael G.; Xiong, Maggie; Pasternak, Jesse D.; Abdulrasool, Layth; Ogawa, Lauren; Suh, Insoo; Gosnell, Jessica E.; Kaplan, Edwin L.; Duh, Quan‐Yang; Angelos, Peter; Shen, Wen T.; Grogan, Raymon H.

doi:10.1245/s10434-016-5439-1

Cited by 50 publications

(41 citation statements)

References 18 publications

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“…Although PGRIS did not positively influence an early recovery, patients with three or four parathyroid glands remaining in situ still have some chances of recovery after one year of replacement therapy. This means that surgeons should make all possible efforts to preserve the parathyroid glands in situ avoiding autotransplantation, inadvertent parathyroidectomy and thymectomy (12,14,20,21,22,23). A limitation of the study is that 10% of the patients with postoperative hypocalcaemia were lost to follow-up before the final parathyroid status could be assessed.…”

Section: Discussionmentioning

confidence: 99%

Time to parathyroid function recovery in patients with protracted hypoparathyroidism after total thyroidectomy

Villarroya-Marquina

Sancho

Lorente-Poch

et al. 2018

European Journal of Endocrinology

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Section: Discussionmentioning

confidence: 99%

Time to parathyroid function recovery in patients with protracted hypoparathyroidism after total thyroidectomy

Villarroya-Marquina

Sancho

Lorente-Poch

et al. 2018

European Journal of Endocrinology

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“…Finding a parathyroid gland in postoperative thyroidectomy specimen without any intention to do parathyroidecomy is known as incidental parathyroidectomy (IP). The incidence ranges between 6.4% and 31.1% [5][6][7][8][9][10][11]. Over the past decades, standardization of the thyroidectomy technique and advances in perioperative management have led to significant reduction in the overall morbidity [5].…”

Section: Introductionmentioning

confidence: 99%

“…Although IP is considered a minor finding in final histopathology and not a life-threatening complication of thyroid surgery, it is important for the thyroid surgeon to be able to identify factors that increase the risk for IP during thyroidectomy and exercise appropriate caution in those patients [6]. Preoperative diagnosis, type of operation, and presence of nodal metastases may influence the likelihood of IP; however, there is no unanimity of risk factors agreed upon in the literature [7].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Incidental Parathyroidecomy in Thyroid Surgery

Alraddadi

Aldhahri

Almayouf

et al. 2019

Cureus

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Background: Incidental parathyroidectomy with subsequent hypoparathyroidism and postoperative hypocalcemia is thought to be one of the common complications of thyroidectomy. Current literature reports wide discrepancy in incidence and risk factors.Objectives: The aim of our study was to evaluate the incidence and risk factors of incidental parathyroidectomy in thyroid surgery.Methods: A retrospective study included 270 patients who had thyroid surgery that was performed over two years from January 2017 to December 2018 in two tertiary care hospitals. Preoperative and postoperative records were assessed. Factors such as gender, diagnosis, type of surgery, and usage of surgical loupes during the procedure were evaluated and were compared to find the association with incidental parathyroidectomy in thyroid surgery.Results: Incidental parathyroidectomy was noticed in 62 (23%) surgical specimens during histopathologic examination. There was no significant association between incidental parathyroidectomy and sex of patient, use of surgical loupes, pathology of thyroid disease, or neck dissection.Conclusion: Although the risk of incidental parathyroidectomy is inevitable, careful dissection and meticulous intraoperative identification of parathyroid gland during thyroidectomy can reduce the incidence of incidental parathyroidectomy, thereby minimizing the risk of postoperative hypoparathyroidism and hypocalcemia.

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“…[2] A recent study noted that patients with incidental parathyroidectomy are more likely to have biochemical and symptomatic hypocalcemia following thyroid surgery. [3] However, even in the hands of an experienced surgeon, an incidental parathyroidectomy may still occur.…”

Section: Introductionmentioning

confidence: 99%

Unintentional parathyroidectomy during total thyroidectomy surgery

Fang

Zhang

et al. 2017

Medicine

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In this study, we investigated incidental parathyroidectomy during total thyroidectomy surgery that required central lymph node dissection and the potential risk factors. Patients requiring total thyroidectomy and tracheoesophageal groove node dissection were enrolled in the study from January 2013 to June 2015 and we obtained all medical information, including pathology reports. Furthermore, we recorded the parathyroid hormone level in all patients prior to operation and then 3 further times: 1 day, 1 week, and 3 months after surgery. A total of 341 patients (66 male and 275 female) were enrolled in the study. Microscopic examination of postoperative specimens revealed that incidental parathyroidectomy existed in 35 (10.3%) cases: 32 (91.4%) patients had 1 parathyroid gland excised, 3 (8.6%) patients had 2 parathyroid glands excised, and no patients had 3 or more parathyroid glands resected. The mean size of the resected glands was 4.6 mm. Parathyroid tissue from 16 (42.1%) cases was located in the intrathyroidal position, 6 glands were located in central lymphatic adipose tissue, and 16 glands were located within or along with thymus tissue. Lateral neck dissection significantly increased the risk of incidental parathyroidectomy (P < 0.001). No other factors including age, sex, and postoperative symptomatic hypocalcemia were significantly associated with incidental parathyroidectomy (all P > 0.05), though incidental parathyroidectomy tended to cause transient hypoparathyroidism (P = 0.051). Therefore, the risk of incidental parathyroidectomy in total thyroidectomy is relatively low; the majority of the resected parathyroid tissue is situated outside the thyroid, therefore we suggest future operations focus on preserving the parathyroid gland when the node dissection is close to the thymus. Incidental parathyroidectomy appears to have an effect on the expression of parathyroid hormone and it is significantly associated with lateral cervical lymph node dissection.

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Incidence, Risk Factors, and Clinical Outcomes of Incidental Parathyroidectomy During Thyroid Surgery

Cited by 50 publications

References 18 publications

Time to parathyroid function recovery in patients with protracted hypoparathyroidism after total thyroidectomy

Time to parathyroid function recovery in patients with protracted hypoparathyroidism after total thyroidectomy

Risk Factors of Incidental Parathyroidecomy in Thyroid Surgery

Unintentional parathyroidectomy during total thyroidectomy surgery

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