Unpredictable nightmare in thyroid surgery: Incidental Parathyroidectomy

Abstract

Background: Incidental removal of the parathyroid gland is an unwanted minor complication of thyroidectomy and would occur even in experienced centers. The purpose of this study was to evaluate our clinic’s outcomes, incidence, and risk factors for incidental parathyroidectomy. 
 Methods: A total of 627 patients with an average age of 50.74±12.68 years were included in the study. Seventy-eight point nine percent of the patients had bilateral total thyroidectomy, 11.2% had a total lobectomy with isthmectomy, 4.8% had completed thyroidectomy, 4% had bilateral total thyroidectomy with bilateral central dissection and 1.1% had bilateral subtotal thyroidectomy. Incidental parathyroidectomy was observed in 6.4% (n=40) of all patients.
 Results: There was a significant correlation between incidental parathyroidectomy and bilateral total thyroidectomy and bilateral central neck dissection. There were no statistically significant differences between the incidental and nonincidental parathyroidectomy group with respect to age and gender. While the preoperative diagnosis of hyperthyroidism (20.6% vs 7.5%) was significantly higher in the non-incidental parathyroidectomy group than in the incidental parathyroidectomy group, and the diagnosis of malignancy was significantly higher in the incidental parathyroidectomy group (32.5% vs. 11.6%, p=0.001). Regarding parathyroid localization, our incidental parathyroidectomy rate was higher in intrathyroidal localized cases. Postoperative transient hypocalcemia (62.5%) was higher in the incidental parathyroidectomy group than in the non-incidental parathyroidectomy group (34.4%, p