Evaluation of patients who have undergone unintentional parathyroidectomy following thyroidectomy: a retrospective cohort study

Abstract

Aim: We investigated the postoperative parathormone levels and the incidence of hypocalcemia in patients who had inadvertently underwent parathyroidectomy during thyroid surgery . Material and Methods: We retrospectively evaluated a total of 142 patients who had undergone thyroidectomy between January 2011 and March 2017 from their charts. The demographic feature sand pathology diagnoses of the thyroidectomy patients were evaluated. The number of excised parathyroid glands in the pathology specimens and their location were determined. The PTH level was checked after surgery. Calcium was measured on the 2nd day. Calcium replacement was provided for patients with low PTH and calcium. The level of calcium replacement was determined by referring to biochemical values. Following discharge, the calcium and PTH levels were checked during outpatient visits to determine whether the hypocalcemia was transient or permanent. Results: The 142 patients consisted of 23 males (16.2%) and 119 females (83.8%). The mean age was 49.5 years. The surgery performed was bilateral total thyroidectomy in 131, bilateral subtotal thyroidectomy in 3, left total right subtotal thyroidectomy in 3, right total leftsubtotalthyroidectomy in 2, left thyroid lobectomy in 2, and complementary thyroidectomy in 1. Unilateral neck dissection (level II, III, IV, V) was performed in 2 patients and central lymphnode dissection in 82 patients. Parathyroid tissue was found to have been excised during surgery in 35 patients, consisting of 33 females (94.2%) and 2 males (5.8%). The parathyroid tissue had been removed incidentally in 31 and not incidentally in 4. We found transient hypocalcemia in 42 patients and permanent hypocalcemia in 2 patients. Discussion: We found that some parathyroid glands had been inadvertently removed despite careful thyroid surgery. We believe that checking the PTH level postoperatively is important in determining hypocalcemia. Conclusion: