Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences

Area of Science:

• Endocrinology
• Surgical Oncology

Background:

• Total thyroidectomy is a common surgical procedure.
• Accidental parathyroidectomy is a known complication.
• Understanding its incidence and consequences is crucial for patient management.

Purpose of the Study:

• To determine the incidence of accidental parathyroidectomy during total thyroidectomy.
• To assess the clinical and biochemical outcomes following accidental parathyroidectomy.
• To identify potential risk factors associated with this complication.

Main Methods:

• Retrospective analysis of 281 patients undergoing total thyroidectomy from 2006-2015.
• Review of pathology reports to identify incidental parathyroidectomy.
• Comparison of clinical, pathological, and biochemical factors between patients with and without parathyroidectomy.

Main Results:

• Incidental parathyroidectomy was observed in 24.9% of cases, with 44.3% of parathyroid glands being intrathyroidal.
• Biochemical hypocalcemia was significantly higher in the parathyroidectomy group (28.6%) versus the no-parathyroidectomy group (13.3%).
• No significant difference in symptomatic hypocalcemia was found between the groups.

Conclusions:

• Incidental parathyroidectomy is associated with transient biochemical hypocalcemia post-total thyroidectomy.
• Clinical symptoms of hypocalcemia were not significantly increased.
• Age, sex, thyroid weight, Hashimoto thyroiditis, and malignancy are not identified as risk factors.