Incidental parathyroidectomy is a frequent complication of thyroid surgery. A retrospective study of 3065 patients

Abstract

AIM: The aim of the present study is to investigate the incidence of accidental parathyroidectomy and the connection between the type of surgery, or the resected piece sent for histopathological examination and the number of accidentally excised parathyroid glands.

MATERIAL AND METHODS: Patients who had thyroid surgery between January 2005 and December 2014 and were admitted to a surgery clinic from Targu Mures, Romania, were enrolled in this study. For statistical analysis we used Chi-squared test, Student’s t-test and ANOVA test, with a p value < 0.05 considered statistically significant.

RESULTS: A total of 3065 patients (315 males, 2750 females) were included in our study, with a mean age of 49.66±13.73. The frequence of incidental parathyroidectomy was 15.36%, most patients with IPT (88.95%) had only one parathyroid gland removed and we found a statistically significant association (p = 0.01) between the incidence of IPT and the type of surgery.

DISCUSSION: Iatrogenic injury of the parathyroid glands cause hypoparathyroidism which can be transient in majority and permanent in 1.5% of the patients. The most frequent cases with accidental removal of the parathyroid glands were total and subtotal thyroidectomies (79.6%), respectively reinterventions or completion thyroidectomies (10.62%).

CONCLUSIONS: Incidental parathyroidectomy is not uncommon following thyroid surgery, even in the hands of experienced surgeons and it is more often seen in female patients with polynodular goiter according to our study. Total thyroidectomies and reinterventions on the thyroid gland increase the risk of incidental parathyroidectomy.