Unintentional parathyroidectomy during total thyroidectomy

Abstract

Unintentional parathyroidectomy, although common, has no clinical consequences. Unlike surgeon's experience and operative technique, patient sex was the only factor affecting its occurrence.

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

“…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.…”

“…The correlation of female gender with a higher incidence of IP has been previously reported (14,25). On the contrary, Manouras et al and Sakorafas et al have reported a lower incidence of IP in males and 2 other studies found that sex did not affect the IP rate (9,23,24,26). Females in our study had less intrathyroidal inadvertently removed PG compared to males (14% vs. 20%).…”

“…The respective numbers reported in the literature are 1.2-4.8% and 16-68.8% (9,17,20,23,27,28). There is considerable deviation between institutions as to what is considered a true PG which may explain why there is such a big range of reported intrathyroidal PGs in the literature.…”

“…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.…”

Tri-modal microscope for head and neck tissue identification

“…While thyroidectomy is considered a safe surgery, complications may arise. Inadvertent removal of or damage to the parathyroid is the most common complication, with iatrogenic removal ranging from 9 to 21% of cases [4]. Inadvertent damage is harder to quantify, but studies relate transient or permanent hypocalcaemia to damage to, and/or removal of, parathyroid glands.…”