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Incidental parathyroidectomy during thyroid resection: incidence, risk factors, and outcome
Gamal Ahmed Khairy1, Abdulaziz Al-Saif
1Department of Surgery, Division of General Surgery, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia. drgamalk@gmail.com
Background And Objectives:
Thyroidectomy is a commonly performed procedure for thyroid problems. Inadvertent removal of the parathyroid glands is one of its recognized complications, which occurs more frequently in certain high-risk patients. The aim of this study was to identify the incidence, risk factors, and clinical relevance of incidental parathyroidectomy during thyroid surgery.
Design And Setting:
A retrospective review of thyroid operations performed at a tertiary referral hospital between January 2004 and December 2008.
Methods:
Pathology reports were reviewed to identify the specimens that included parathyroid tissue and underlying thyroid pathology. Postoperative calcium levels were reviewed in these patients.
Results:
During the study period, 287 thyroidectomies were performed and 47 (16.4%) patients had incidentally removed parathyroid glands. Risk factors for inadvertent parathyroid resection included total thyroidectomy (P=.0001), Hashimoto thyroiditis (P=.004), and extrathyroidal spread (P=.0003). Postoperative hypocalcemia occurred in 18 (38.3%) of the patients in whom the parathyroid gland was removed inadvertently and in 48 (20%) of the rest of the patients (P=.0123).
Conclusion:
The incidence of incidental removal of parathyroid tissue during thyroidectomy is 16.4%. Total thyroidectomy, extrathyroidal extension of the tumor, and thyroiditis were found to be the risk factors. Hypocalcemia was significantly higher among patients who had inadvertent parathyroidectomy.
