The Relationship between Unintentional Parathyroidectomy and Postoperative Hypocalcemia

Kim, Jae Won; Shin, Jun Sun; Choi, Jeong Seok; Ju, Young Chae; Kim, Young Mo

Abstract

BACKGROUND AND OBJECTIVES
Preservation of parathyroid gland during thyroid surgery is important to prevent postoperative hypocalcemia. We evaluated the incidence of unintentional parathyroidectomy during thyroid surgery and postoperative hypocalcemia, and their clinical relationships. MATERIALS AND METHOD: 136 patients who had undergone thyroid surgery were retrospectively followed. We reviewed the pathology specimens to determine the incidence of unintentional removal of parathyroid tissue and inquired the incidence of postoperative hypocalcemia according to the pathology of tumor, the extent of surgery, and the locations of the parathyroid tissues. RESULTS: 27 patients (19.9%) had pathology reports showing parathyroid tissue contained within the thyroidectomy specimen. Unintentional parathyroidectomy was less correlated with postoperative transient hypocalcemia statistically. The postoperative transient hypocalcemia was more frequent after total thyroidectomy for malignant thyroid tumor than hemithyroidectomy for benign thyroid tumor. Most parathyroid tissues were found in extracapsular locations. CONCLUSION: Unintentional parathyroidectomy was reported in 19.9% of the thyroidectomies in our studies. More meticulous dissection of thyroid capsule may be needed, especially during total thyroidectomy for malignant thyroid tumor.