Inadvertent parathyroid excision during thyroid surgery

Rix, Thomas; Sinha, Prakash

doi:10.1016/s1479-666x(06)80108-3

Cited by 29 publications

(34 citation statements)

References 9 publications

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“…The association of completion thyroidectomy with IPE has been reported extensively in literature. While Rix and Sinha26 showed a strong statistically significant association, in our study, completion thyroidectomy was not found to be a strong risk factor, despite the surgical difficulties expected with the re-exploration of the neck.…”

Section: Discussioncontrasting

confidence: 72%

Incidental parathyroidectomy during thyroid resection: incidence, risk factors, and outcome

Khairy

Alsaif

2011

Annals of Saudi Medicine

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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.

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Section: Discussioncontrasting

confidence: 72%

Incidental parathyroidectomy during thyroid resection: incidence, risk factors, and outcome

Khairy

Alsaif

2011

Annals of Saudi Medicine

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“…The IP rate in our large cohort of patients was 11.3% which falls within the range of IP rates published previously (3.7-28.0%) (5,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Our study is the first study, to our knowledge, to investigate in depth the effect of the presence of LN to the incidence of IP.…”

Section: Discussionsupporting

confidence: 85%

“…Most studies have reported that IP doesn't significantly affect post-operative serum calcium levels (1,4,5,11,12,(14)(15)(16)19,21,22). Only a small number of studies have positively correlated the occurrence of IP with a higher incidence of hypocalcaemia (8,20,24,27 (29).…”

Section: Discussionmentioning

confidence: 99%

“…A number of studies in the literature have published conflicting evidence on the factors that influence IP, a result of the small number of patients included, differences in practises between centres and variations in the population included in the studies (5,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). The purpose of this study was to evaluate the incidence of IP during thyroid operations in a large single centre case series during a period of 6 years and identify the risk factors involved.…”

Section: Introductionmentioning

confidence: 99%

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Inadvertent parathyroidectomy risk factors in 1,373 thyroidectomies—male gender and presence of lymphadenopathy, but not size of gland, independently increase the risk

et al. 2017

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Background: Inadvertent parathyroidectomy (IP) during thyroid operations is a recognised phenomenon.We evaluated the incidence of IP during thyroid operations in a large case-series and identified the risk factors involved. Results: One thousand three hundred and seventy-three patients were included in our study, 1,149 of them females (84%). IP rate was 11.3%. Univariate analysis showed that gender, thyroid gland weight, thyroid activity pre-operatively and type of operation are associated with IP. Logistic regression analysis has shown that female gender and the absence of LN in pathology were associated with less likelihood in developing IP than males and patients with presence of LN (P=0.051 and 0.014 respectively). IP occurs 2.14 and 2.28 times more often in TT and NTT when compared to the combination of TT and NTT (P=0.047 and 0.048 respectively). Conclusions:We present the largest single-centre case series on this topic, to our knowledge. The presence of LN, female gender and the type of operation are positively correlated to the IP rate. These factors could alert the surgeon to consider early calcium supplementation if the parathyroid glands (PG) have not been identified intraoperatively.

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“…The 61 patients in Group-2 with 2 parathyroid glands identified had only 23 % of the patients with features of hypocalcaemia and the patients in Group-3 had 96% with calcium level >8 mg/dl without features of hypocalcaemia as reported in the earlier studies. [11][12][13][14] The risk of hypocalcaemia (<8 mg/dl) decreases from Group 1 to Group 3, as the number of parathyroid glands identified meticulously during surgery increases from less than to more than two.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study on the incidence of hypocalcemia and number of parathyroid glands identified and preserved during thyroid surgeries

Pauly

Santhosh

et al. 2016

Int J Res Med Sci

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Inadvertent parathyroid excision during thyroid surgery

Cited by 29 publications

References 9 publications

Incidental parathyroidectomy during thyroid resection: incidence, risk factors, and outcome

Incidental parathyroidectomy during thyroid resection: incidence, risk factors, and outcome

Inadvertent parathyroidectomy risk factors in 1,373 thyroidectomies—male gender and presence of lymphadenopathy, but not size of gland, independently increase the risk

A retrospective study on the incidence of hypocalcemia and number of parathyroid glands identified and preserved during thyroid surgeries

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