An Undesirable Post-Thyroidectomy Surprise for the Surgeon: Inadvertent Parathyroidectomy

Abstract

Objectives: This study aims to report the incidence of inadvertent parathyroid gland removal during thyroidectomies, as documented by pathology reports, and investigate its association with hypocalcemia. Materials and Methods: The patients who underwent thyroidectomy at our department between 2009 and 2013 were retrospectively reviewed. The patients who had standard total thyroidectomy were included in the study. Data on patient demographics, surgical reports, experience of surgeons, anatomical localization of excised parathyroid glands (PG) and laboratory results were evaluated. Patients were divided into two groups according to the presence or absence of an excised PG in the histopathology report (group P: presence of PG, and group T: absence of PG). Results: A total of 343 patients were included to study. Of these, 26 patients were in group P, and 317 in group T. Post-operative hypocalcemia was encountered in 37 patients. Hypocalcemia rates were similar between two groups (p=0.45). Surgical experience was found to decrease the rate of Inadvertent parathyroidectomy (IP) (p=0.04), however, it wasn't associated with post-operative hypocalcemia (p=0.72). Conclusion: IP is an undesirable finding that can be encountered by surgeons. Our findings showed that IP was found to be associated with surgical experience. However, these results were not associated with post-operative hypocalcemia.Amaç: Bu çalışmada tiroidektomi sırasında istenmeden çıkartılan ve patoloji raporlarında saptanan paratiroid bezlerinin insidansının saptanması ve hipokalsemi gelişimi ile ilişkisinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Kliniğimizde 2009 ile 2013 yılları arasında tiroidektomi uygulanan hastalar retrospektif olarak değerlendirildi. Standart total tiroidektomi yapılan olgular çalışmaya dahil edildi. Hastalara ait demografik veriler, ameliyat raporları, cerrahların deneyimi, eksize edilen paratiroid bezinin (PB) anatomik lokalizasyonu ve laboratuvar sonuçları değerlendirildi. Hastalar histopatoloji raporunda paratiroid bezi saptanan ve saptanmayanlar olmak üzere iki gruba ayrıldı. (grup P: PB saptananlar, and group T: PB saptanmayanlar). Bulgular: Çalışmaya toplam 343 hasta dahil edildi. Bunlar içerisinden, 26 hasta grup P'de, 317'si ise grup T'de yer aldı. Otuz yedi hastada postoperatif dönemde hipokalsemi saptandı. Hipokalsemi oranları her iki grupta benzerdi (p=0,45). Cerrahi deneyimin istemeden yapılan paratiroidektomi (İP) oranını düşürdüğü görüldü (p=0,04), ancak postoperatif hipokalsemi ile ilişkisi saptanmadı (p=0,72). Abstract Öz