Incidental parathyroidectomy during thyroidectomy increases the risk of postoperative hypocalcemia

Yann Sheng Lin, Chuen Hsueh, Hsin Yi Wu, Ming Chin Yu, Tzu Chieh Chao*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

33 Scopus citations

Abstract

Objectives/Hypothesis: The correlation between incidental parathyroidectomy (IP) during thyroidectomy and postoperative hypocalcemia remains controversial. Our aim was to investigate the incidence of IP, risk factors, and impact on patient outcomes. Study Design: Retrospective cohort study. Methods: This was a retrospective observational study including 3,186 consecutive patients who underwent thyroidectomy between January 2007 and December 2014. The patients were divided into two groups: the IP group and the non-IP. Numerous clinical parameters were collected and analyzed. Results: The overall incidence of incidentally excised parathyroid glands during thyroidectomy was 6.4%. Patients with IP had significantly higher incidences of postoperative hypocalcemia and hypoparathyroidism than those without IP (P < 0.001). Intrathyroidal parathyroid glands presented only 2.2% of all removed parathyroid glands. Total thyroidectomy, central compartment lymph node dissection, and reoperation were independent risk factors for IP. Conclusion: Incidental parathyroidectomy during thyroidectomy is associated with the increased likelihood of postoperative hypocalcemia. All independent risk factors examined in the study for IP are surgery-related. Surgeons should perform meticulous dissection with the intention of avoiding IP and resultant hypocalcemia. Level of Evidence: 4. Laryngoscope, 127:2194–2200, 2017.

Original languageEnglish
Pages (from-to)2194-2200
Number of pages7
JournalLaryngoscope
Volume127
Issue number9
DOIs
StatePublished - 09 2017

Bibliographical note

Publisher Copyright:
© 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Keywords

  • Incidental parathyroidectomy
  • central neck lymph node dissection
  • hypoparathyroidism
  • postoperative hypocalcemia
  • thyroidectomy

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