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SURGICAL AUDIT OF INADVERTENT PARATHYROIDECTOMY DURING TOTAL THYROIDECTOMY: INCIDENCE, RISK FACTORS, AND OUTCOME
Author(s) -
Janakiraman R.,
Paul M. J.,
Thomas D. A,
Selvan B.,
Nair A.,
Samuel P.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04916_23.x
Subject(s) - medicine , hypocalcaemia , parathyroidectomy , incidence (geometry) , thyroidectomy , surgery , parathyroid gland , endocrine surgery , thyroid , hypoparathyroidism , neck dissection , medical record , cancer , parathyroid hormone , physics , optics , calcium
Objectives: To assess the incidence, risk factors and clinical relevance of inadvertent parathyroidectomy during thyroidectomy. Design: Retrospective study. Setting: Tertiary care hospital and post‐graduate teaching institute. Subjects & Methods: Patients who underwent total thyroidectomy between 2004 and 2006 (three years) in a general surgical unit with a special interest in endocrine surgery were included in the study. Medical records were accessed for patient demographic data, diagnosis, operative details, histopathology reports, postoperative hypocalcaemia and the total duration of hospital stay. Results: Inadvertent removal of parathyroid glands occurred in 12.9% of cases. Removed parathyroids were intra‐capsular / intra‐thyroidal in 44.6% of cases. Female sex, malignancy and central neck dissection were found to be risk factors. These patients had an increased incidence of temporary and permanent biochemical hypocalcaemia but the hospital stay was not prolonged. Conclusion: In our study, inadvertent parathyroid excision accounted for increased morbidity. Steps should be taken to preserve more parathyroid glands by improving surgical technique (magnification) and auto‐transplantation of parathyroid gland if necessary.