Unintentional Parathyroidectomy During Thyroidectomy

Abstract

Incidental parathyroid gland tissue was reported in 11% of the thyroidectomies performed in our series, without the clinical consequence of hypocalcemia. The majority (78%) of this parathyroid tissue was found in the extracapsular and intracapsular locations; therefore it is possible that these parathyroid glands may be identified and preserved with more meticulous inspection of the thyroid capsule during and after thyroidectomy to decrease the incidence of unintentional parathyroidectomy during thyroidectomy in the future.

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

“…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.…”

“…Most studies have reported that IP doesn't significantly affect post-operative serum calcium levels (1,4,5,11,12,(14)(15)(16)19,21,22). Only a small number of studies have positively correlated the occurrence of IP with a higher incidence of hypocalcaemia (8,20,24,27 (29).…”

“…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.…”

Incidental parathyroidectomy during thyroid resection: incidence, risk factors, and outcome

“…In the current study, about 43% of the incidentally resected parathyroids were intrathyroidal. Intrathyroidal location of parathyroids has been described in about 2% to 5% of autopsy studies,1828 and incidentally excised parathyroids have been reported to be in an intrathyroid location in up to 40% to 50% of cases 1421. Thus, incidental parathyroidectomy may occur even in the hands of more experienced thyroid surgeons.…”

Influence of magnesium sulphate infusion before total thyroidectomy on transient hypocalcemia — a randomised study

“…The incidence of an incidentally detected parathyroid tissue in histologic material (10.5%) is comparable to that in other similar studies, yet still at lower level of the incidence range reported in the literature (9-15%). [19][20][21] The incidence of transient hypocalcemia after thyroidectomy reported in the literature differs from study to study 14,[22][23][24][25][26] due to the differences in the reference calcium values of laboratory test, definitions of laboratory transient hypocalcemia and clinical transient hypocalcemia. In our study, the rate of the patients with laboratory transient hypocalcemia (27%) and those with clinically transient hypocalcemia (23%) was in the interval of 6.2-68%, which was simi-lar to that reported in the literature.…”