Inadvertent parathyroidectomy and temporary hypocalcemia: an adverse natural outcome or a true complication during...

The aim of this study was to assess the factors that might predict patients at increased risk for inadvertent parathyroidectomy and postoperative symptomatic hypocalcemia during thyroidectomy.

Demographic data as well as the data on preoperative diagnosis, preoperative ultrasonography reports, operation reports, histological findings, and postoperative symptomatic hypocalcemia were collected. A total of 273 (83 male and 190 female patients) thyroid operations were included in this study.

Histopathological examination identified inadvertent parathyroidectomy in 10 (3.7%) cases. Statistical analysis identified the presence of cervical lymphadenopathy as detected by preoperative ultrasonography as a risk factor for inadvertent parathyroidectomy. In 57 patients (20.9%) clinically symptomatic postoperative hypocalcemia was observed. However, the difference in the frequency of such hypocalcemia between the patients with and without inadvertent parathyroidectomy was not significant. Statistical evaluation identified total thyroidectomy as a risk factor for postoperative hypocalcemia (p<0.005).

Due to our experience, inadvertent parathyroidectomy is not a rare entity during thyroidectomy and the presence of cervical lymphadenopathy, as observed by preoperative ultrasonography, is the only risk factor for inadvertent parathyroidectomy. In contrast, no association between inadvertent parathyroidectomy and postoperative hypocalcemia was detected. Total thyroidectomy was found to be the sole risk factor for symptomatic temporary hypocalcemia.