Clinicopathological characteristics of incidental parathyroidectomy after total thyroidectomy: The effect on hypocalcemia. A retrospective cohort study

Vasileiadis, Ioannis; Charitoudis, Georgios; Vasileiadis, Dimitrios; Kykalos, Stylianos; Karatzas, Theodore

doi:10.1016/j.ijsu.2018.05.737

Cited by 24 publications

(43 citation statements)

References 23 publications

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“…Finding a parathyroid gland in postoperative thyroidectomy specimen without any intention to do parathyroidecomy is known as incidental parathyroidectomy (IP). The incidence ranges between 6.4% and 31.1% [5][6][7][8][9][10][11]. Over the past decades, standardization of the thyroidectomy technique and advances in perioperative management have led to significant reduction in the overall morbidity [5].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence ranges between 6.4% and 31.1% [5][6][7][8][9][10][11]. Over the past decades, standardization of the thyroidectomy technique and advances in perioperative management have led to significant reduction in the overall morbidity [5]. Although IP is considered a minor finding in final histopathology and not a life-threatening complication of thyroid surgery, it is important for the thyroid surgeon to be able to identify factors that increase the risk for IP during thyroidectomy and exercise appropriate caution in those patients [6].…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors of Incidental Parathyroidecomy in Thyroid Surgery

Alraddadi

Aldhahri

Almayouf

et al. 2019

Cureus

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Background: Incidental parathyroidectomy with subsequent hypoparathyroidism and postoperative hypocalcemia is thought to be one of the common complications of thyroidectomy. Current literature reports wide discrepancy in incidence and risk factors.Objectives: The aim of our study was to evaluate the incidence and risk factors of incidental parathyroidectomy in thyroid surgery.Methods: A retrospective study included 270 patients who had thyroid surgery that was performed over two years from January 2017 to December 2018 in two tertiary care hospitals. Preoperative and postoperative records were assessed. Factors such as gender, diagnosis, type of surgery, and usage of surgical loupes during the procedure were evaluated and were compared to find the association with incidental parathyroidectomy in thyroid surgery.Results: Incidental parathyroidectomy was noticed in 62 (23%) surgical specimens during histopathologic examination. There was no significant association between incidental parathyroidectomy and sex of patient, use of surgical loupes, pathology of thyroid disease, or neck dissection.Conclusion: Although the risk of incidental parathyroidectomy is inevitable, careful dissection and meticulous intraoperative identification of parathyroid gland during thyroidectomy can reduce the incidence of incidental parathyroidectomy, thereby minimizing the risk of postoperative hypoparathyroidism and hypocalcemia.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk Factors of Incidental Parathyroidecomy in Thyroid Surgery

Alraddadi

Aldhahri

Almayouf

et al. 2019

Cureus

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“…Some studies have shown that inadvertent parathyroidectomy is approximately 18% during thyroid surgery, while patients experience temporary hypocalcemia (28.9%‐30.7%) and permanent hypocalcemia (1.6%‐9.6%) after thyroid surgery .…”

Section: Introductionmentioning

confidence: 89%

Video‐assisted parathyroid gland mapping with autofocusing

Kim

Lee

et al. 2019

Journal of Biophotonics

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Preservation of the parathyroid gland (PTG) in neck endocrine surgery is important for regulating the amount of calcium in the blood and within the bones. Localization of the PTG has been attempted using various methods such as ultrasound, sestamibi, computerized tomography, magnetic resonance imaging and indocyanine green fluorescence imaging. These methods cannot be used during surgery, have high sensitivity or have PTG specificity. However, autofluorescence technique has shown high sensitivity and does not require exogenous contrast. In this study, a new optical system was designed and developed into a clinical system. The system enabled easier and faster focusing on the surgical area and high‐resolution video imaging while maintaining a clear image. The system was located above the head of the surgeon. The surgeon was able to see the real‐time autofluorescent image on the monitor next to the operating table at any time to locate the PTG. The PTG buried in the adipose tissue and connective tissue was located easily and accurately. The clinical trial conducted in this study consisted of 56 parathyroid cases in 26 patients. For the statistical results, the sensitivity and accuracy in this redesigned autofluorescent imaging system were 98.1% and 96.4%, respectively.

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“…The primary treatment for thyroid cancer is removal of the thyroid tissue containing the lesions, a procedure called thyroidectomy. [5][6][7] There is also economic burden due to the need to take calcium and vitamin D supplements. [1,2] However, it is difficult to clearly distinguish the parathyroid glands from neighboring tissues because they are similar in color to the naked eye, the surgeon may lack the experience and some patients have a lot of fat tissue around the thyroid.…”

Section: Introductionmentioning

confidence: 99%

“…[3,4] The incidence of iatrogenic injury of parathyroid glands is 0.6% to 9.2% in all thyroid surgeries. [5][6][7] There is also economic burden due to the need to take calcium and vitamin D supplements.…”

Section: Introductionmentioning

confidence: 99%

Phase‐sensitive fluorescence detector for parathyroid glands during thyroidectomy: A preliminary report

Kim

Lee

et al. 2019

Journal of Biophotonics

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Despite advances in medical technology, the parathyroid glands are still damaged during thyroid surgery. Our previous studies exploring methods for locating the parathyroid glands using autofluorescence have limitations, such as turning off the surgical light or requiring additional matching between the autofluorescence image and realsurgical field-of-view. We developed a probe-type parathyroid autofluorescence detector using a phase-sensitive process and optical filtering to overcome these limitations. A preliminary clinical trial was performed on eight parathyroid glands in four patients. The normalized mean signal of the normal parathyroid glands was 332% stronger than that of the thyroid, and 384%, 459% and 286% stronger than the signal of the muscle, trachea and fat, respectively. Additionally, the device also detected fluorescence from indocyanine green. K E Y W O R D Sautofluorescence, clinical, optical filter, parathyroid gland, phase-sensitive Abbreviations: FOV, field-of-view; ICG, indocyanine green; P/T ratio, parathyroid/thyroid intensity ratio; SNR, signal-to-noise ratio.

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Clinicopathological characteristics of incidental parathyroidectomy after total thyroidectomy: The effect on hypocalcemia. A retrospective cohort study

Cited by 24 publications

References 23 publications

Risk Factors of Incidental Parathyroidecomy in Thyroid Surgery

Risk Factors of Incidental Parathyroidecomy in Thyroid Surgery

Video‐assisted parathyroid gland mapping with autofocusing

Phase‐sensitive fluorescence detector for parathyroid glands during thyroidectomy: A preliminary report

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