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Inadvertent parathyroid excision during thyroid surgery.

T E Rix1, P Sinha

  • 1Department of General Surgery, William Harvey Hospital, Ashford, Kent, UK. tomrix@msn.com

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
|December 13, 2006
PubMed
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Thyroid surgery has a 17% risk of inadvertent parathyroid gland removal, but this does not lead to post-operative hypocalcemia. Careful dissection minimizes removing multiple glands.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • General Surgery

Background:

  • Thyroidectomy is a common procedure for thyroid disease.
  • Inadvertent parathyroid gland removal is a known complication.
  • This complication can affect long-term calcium homeostasis.

Purpose of the Study:

  • To determine the incidence of parathyroid gland excision during thyroid surgery.
  • To assess the impact of inadvertent parathyroidectomy on post-operative calcium control.

Main Methods:

  • Retrospective review of thyroid operations from 2001-2004.
  • Pathology reports were analyzed to identify parathyroid tissue in surgical specimens.
  • Post-operative serum calcium levels were reviewed for relevant patients.

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Main Results:

  • 126 thyroid operations were performed; 17.4% involved inadvertent parathyroid tissue removal.
  • Inadvertent removal occurred in 16.7% of thyroidectomies and 17.7% of lobectomies.
  • No patients experienced post-operative hypocalcemia; all were normocalcemic at six weeks.

Conclusions:

  • Thyroid surgery carries an approximate 17% risk of single parathyroid gland removal in specialist hands.
  • Inadvertent parathyroidectomy does not appear to cause post-operative hypocalcemia.
  • Meticulous capsular dissection can reduce the incidence of removing multiple parathyroid glands.