Incidental Parathyroidectomy in Surgical Treatment of Thyroid Gland Diseases
Authors:
M. Žárska; P. Hanzel; A. Hajtman
Authors place of work:
Klinika ORL a ChHaK JLF UK a UNM v Martine, prednosta prof. MUDr. A. Hajtman, Ph. D.
Published in the journal:
Otorinolaryngol Foniatr, 64, 2015, No. 4, pp. 201-204.
Category:
Original Article
Summary
Introduction:
Incidental parathyroidectomy is one of the complications of thyroid surgery. In this study, we investigated the frequency, risk factors, clinical and laboratory symptoms of incidental parathyroidectomy.
Materials and methods:
The retrospective study included 419 patients who had undergone thyroid surgery in our department between January 2011 and December 2013. The incidental parathyroidectomy was identified based on the pathological reports. For statistical purpose we use the CHI – test.
Results:
419 patients were enrolled in the study. The number of incidental parathyroidectomy cases was determined as 26 (6.2%). In 3 cases, two parathyroid glands were excised. The laboratory values of hypocalcaemia were observed in 133 patients (31.74%), 29 of them had clinical symptoms of hypocalcaemia (6.92%). In the group of 26 patients with the incidental parathyroidectomy, there were 5 of them with clinical and laboratory signs of hypocalcaemia. In the group of 393 patients without incidental parathyroidectomy, there were 128 patients (32.57%) with low calcium levels and 24 patients (6.1%) with clinical signs of hypocalcaemia. In the group of patients with incidental parathyroidectomy the rate of clinical signs of hypocalcaemia was statistically higher (P=0.01).
Risk factors for inadvertent parathyroid resection included malignant etiology (P<0.05). Bilateral thyroid resection wasn't significant risk factor (P>0.05).
Conclusion:
Papillary thyroid carcinoma is the risk factor of the incidental parathyroidectomy. In the group of patients with incidental parathyroidectomy the rate of symptomatic hypocalcaemia is significantly higher.
Keywords:
incidental parathyroidectomy, hypocalcaemia, parathyroid glands, thyroid surgery
Zdroje
1. Abboud, B.: Topographic anatomy and arterial vascularization of the parathyroid glands: practical application. Presse Med., 13, 1996, 25, s. 1156-1161.
2. Begarmashi, R., Becouarn, G., Roncera,Y. J., Arnaud, J. P.: Morbidity of thyroid surgery. Am. J. Surg., 176, 1998, 1, s. 71-75.
3. Butterworth, P. C., Nicholson, M. L.: Surgical anatomy of the parathyroid glands in secondary hyperparathyroidism. J. R. Coll. Surg. Edinb., 43, 1998, s. 271-273.
4. Campos, N. S., Cardozo, L. P., TanioS, R. T., de Oliveira, B. C., Guimaraes, A.V., Dedivitis, R. A., Macopito, L. F.: Risk factors for incidental parathyroidectomy during thyroidectomy. Brazilian Journal of Otorhinolaryngology, 78, 2012, 1, s. 75-61.
5. Čihák, R.: Anatomie 2. Grada Publishing, Praha, 2002, s. 406-407.
6. Erbil, Y., Barbados, U., Ozbey, N., Aral, F., Ozarmagan, S.: Risk factors of incidental parathyroidectomy after thyroidectomy for benign thyroid disorders. International Journal of Surgery, 7, 2009, 1, s. 58-61.
7. Gourgiotis, S., Moustafellos, P., Dimopoulos, N., Papaxoinis, G., Baratsis, S., Hadjivannakis, E.: Inadvertent parathyroidectomy during thyroid surgery: the incidence of a complication of thyroidectomy. Langenbecks Arch. Surg., 134, 2006, 6, s. 557-560.
8. Halsted, W. S., Evans, H. M.: The parathyroid glandules. Their blood supply and their preservation in operations upon the thyroid gland. Ann. Surg., 46, 1907, s. 489-506.
9. Chiang, F. Y., Wang, L. F., Huang, Y. F., Lee, K. W., Kuo, W. R.: Recurrent laryngeal nerve palsy after thyroidectomy with routine identification of the recurrent laryngeal nerve. Surgery, 137, 2005, 3, s. 342-347.
10. Ignatovic, M., Cuk, V., Ozegovic, A., Cerovic, S., Kostic, Z, Romic, P.: Early complications in surgical treatment of thyroid diseases: analysis of 2100 patients. Acta Chir. Iugosl., 50, 2003, 3, s. 155-175.
11. Khairy, G. A., Al-Saif, A.: Incidental parathyroidectomy during thyroid resection: incidence, risk factors, and outcome. Ann. Saudi Med., 31, 2011, 3, s. 274-278.
12. Nobori, M., Saiki, S., Tanaka, N., Harihara, Y., Shindo, S., Fujimoto, Y.: Blood supply of the parathyroid gland from the superior thyroid artery. Surgery, 115, 1994, 4, s. 417-423.
13. Ondik, M. P., McGinn, J., Ruggiero, F., Goldenberg, D.: Unintentional parathyroidectomy and hypoparathyroidism in secondary central compartment surgery for thyroid cancer. Head Neck, 32, 2010, 4, s. 262-266.
14. Ozogul, B., Nuran Akcav, M., Kisaoglu, A., Atamanalp, S. S., Ozturk, G., AvdinlI, B.: Incidental parathyroidectomy during thyroid surgery: risk factors, incidence, and outcomes. Turk. J. Med. Sci., 44, 2014, 1, s. 84-88.
15. Pattou, F., Combermale, F., Fabre, S., Carnaille, B., Decoulx, M., Wemeau, J. L., Racadot, A., Proye, C.: Hypocalcemia following thyroid surgery: incidence and prediction of outcome. World J. Surg., 22, 1998, 7, s. 718-724.
16. Sakorafas, G. H., Stafyla, V., Bramis, C., Kotsifopoulos, N., Kolettis, T., Kassaras, G.: Incidental parathyroidectomy during thyroid surgery: an underappreciated complication of thyroidectomy. World J. Surg., 29, 2005, 12, s. 1539-1543.
17. Sasson, A. R., Pingpank, J. F., Wetherington, R. W., Hanlon, A. L., Ridge J. A.: Incidental parathyroidectomy during thyroid surgery does not cause transient symptomatic hypocalcemia. Arch. Otolaryngol. Head Neck Surg., 127, 2001, 3, s. 304-308.
18. Udelsman, R., Chen, H.: The current management of thyroid cancer. Adv. Surg., 33, 1999, s. 1-27.
19. Wang, C.: The anatomic basis of parathyroid surgery. Ann. Surg., 183, 1976, 3, s. 271-275.
20. Weiss, A., Lee, K. C., Brumund, K. T., Chang, D. C., Bouvet, M.: Risk factors for hematoma after thyroidectomy: results from the nationwide inpatient sample. 156, 2014, 2, s. 399-404.
21. Youssef, T., Gaballah, G., Abd-Elaal, E., El-Dosoky, E.: Assessment of risk factors of incidental parathyroidectomy during thyroid surgery: A prospective study. International Journal of Surgery, 8, 2010, 3, s. 207-211.
Štítky
Audiology Paediatric ENT ENT (Otorhinolaryngology)Článok vyšiel v časopise
Otorhinolaryngology and Phoniatrics
2015 Číslo 4
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