Incidental extirpation of the parathyroid glands at thyroid surgery: risk factors and post-operative hypocalcemia

Qasaimeh, Ghazi; Nemri, Sabah Al; Omari, Abdul Kareem Al

doi:10.1007/s00405-010-1413-x

Cited by 26 publications

(25 citation statements)

References 16 publications

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“…Patients with parathyroid glands that were inadvertently removed during thyroidectomy were more likely to develop permanent hypoparathyroidism, a finding that has also been documented in only a minority of studies [20,22]. Most studies have not found a relationship between IP and permanent hypoparathyroidism [10,21,23,[25][26][27][28][29][30].…”

Section: Accepted Manuscriptmentioning

confidence: 87%

“…The incidence of IP that has been previously published may be an underestimate as not all studies account for intrathyroidal parathyroid glands [20]. Some exclude parathyroid glands that are removed along with tumor [21,22] and others exclude patients with central compartment neck dissection, invasive carcinoma and/or reoperative thyroidectomy [23,24]. Our patient population may have been at higher risk for IP given that 7% of patients underwent reoperative thyroidectomy and 10% underwent concomitant central compartment neck dissection, both of which have been reported to be associated with a higher risk of IP [11].…”

Section: Accepted Manuscriptmentioning

confidence: 98%

“…In our series, thyroid cancer was found to be predictive of IP on univariate analysis and patients with thyroid cancer had a lower mean gland weight. Other studies have suggested that malignant thyroid disease may be a risk factor for IP [10,20,22,24,28,32,33].…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

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Inadvertent parathyroidectomy: incidence, risk factors, and outcomes

Zhou

McHenry

2016

Journal of Surgical Research

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Section: Accepted Manuscriptmentioning

confidence: 87%

Section: Accepted Manuscriptmentioning

confidence: 98%

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Inadvertent parathyroidectomy: incidence, risk factors, and outcomes

Zhou

McHenry

2016

Journal of Surgical Research

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“…Previous studies have variably identified younger age [14, 19, 23], female sex [4, 9, 14], Hashimoto thyroiditis [18, 22], and malignancy [13, 15, 16, 19, 23, 30] as potential risk factors for IPT. Of notice, Sakorafas and Gourgiotis reported lower rates of IPT in patients with malignancy, owing probably to more meticulous dissection in cases of suspected malignancy [4, 10].…”

Section: Discussionmentioning

confidence: 99%

Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences

Manatakis

Balalis

Soulou

et al. 2016

International Journal of Endocrinology

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Objective. To evaluate the incidence of accidental parathyroidectomy in our series of total thyroidectomies, to investigate its clinical and biochemical consequences, and to identify potential risk factors. Methods. Patients who underwent total thyroidectomy between January 2006 and December 2015 were retrospectively analyzed. Pathology reports were reviewed to identify those cases who had an incidental parathyroidectomy and these were compared to patients with no parathyroidectomy, in terms of clinical (age, sex, and symptoms of hypocalcemia), pathological (thyroid specimen weight, Hashimoto thyroiditis, and malignancy), and biochemical (serum calcium and phosphate levels) factors. Results. 281 patients underwent total thyroidectomy during the study period. Incidental parathyroidectomy was noticed in 24.9% of cases, with 44.3% of parathyroid glands found in an intrathyroidal location. Evidence of postoperative biochemical hypocalcemia was noticed in 28.6% of patients with parathyroidectomy, compared with 13.3% in the no-parathyroidectomy group (p = 0.003). Symptomatic hypocalcemia was observed in 5.7% and 3.8%, respectively (p = 0.49). Age, sex, thyroid specimen weight, Hashimoto thyroiditis, and malignancy did not differ significantly between the two groups. Conclusions. Our study found an association of incidental parathyroidectomy with transient postoperative biochemical hypocalcemia, but not with clinically symptomatic disease. Age, sex, thyroid gland weight, Hashimoto thyroiditis, and malignancy were not identified as risk factors.

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“…Some authors (37) have associated the occurrence of symptomatic compressive goiter to a significant risk of postoperative hypocalcemia, while others have reported that the risk of hypocalcemia is greater after surgery performed for malignant tumors (15,41). Dedivitis and cols.…”

Section: Discussionmentioning

confidence: 99%

Use of prophylactic oral calcium after total thyroidectomy: a prospective study

Langner¹,

Tincani

Negro

2017

Arch. Endocrinol. Metab.

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Objective: The aim of this study was to evaluate the use of prophylactic oral calcium after total thyroidectomy in the prevention of symptomatic hypocalcemia, and to develop a rational strategy of oral calcium supplementation following this type of surgery. Subjects and methods: Prospective study including 47 patients undergoing total thyroidectomy from January 2007 to February 2012. The patients were allocated to one of the following groups: I (no postoperative calcium) or II (oral calcium 3 g per day). Oral calcium was started at the first postoperative day and administered until the sixth postoperative day. The patients were followed up for a minimum of 6 months and evaluated with a minimum of five measurements of ionized calcium: preoperative, 16 hours after surgery, seventh postoperative day, and at postoperative days 90 (PO90) and 180 (PO180). The cohort included three men and 44 women, of whom 24 (51.9%) had benign thyroid disease, and 23 had suspected or confirmed malignant disease. Results: When compared with Group II, Group I had significantly higher rates of postoperative biochemical hypocalcemia at PO1 and PO180, and of symptomatic hypocalcemia at PO1, PO7, and PO90. Other data were not significantly different between the groups. Conclusion: We conclude that postoperative calcium supplementation effectively prevents symptomatic and biochemical hypocalcemia after total thyroidectomy, and can be safely used after this procedure. The presented strategy of oral calcium supplementation may be implemented in a viable manner. Arch Endocrinol Metab. 2017;61(5):447-54

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Incidental extirpation of the parathyroid glands at thyroid surgery: risk factors and post-operative hypocalcemia

Cited by 26 publications

References 16 publications

Inadvertent parathyroidectomy: incidence, risk factors, and outcomes

Inadvertent parathyroidectomy: incidence, risk factors, and outcomes

Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences

Use of prophylactic oral calcium after total thyroidectomy: a prospective study

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