Dissection and identification of parathyroid glands during thyroidectomy: Association with hypocalcemia

• Published in: Head & neck Vol. 37; no. 3; pp. 393 - 399
• Main Authors: Praženica, Pavol, O'Keeffe, Leonard, Holý, Richard
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.03.2015; Wiley Subscription Services, Inc
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Analysis of Variance; Cohort Studies; Dissection; Female; Humans; hypocalcemia; Hypocalcemia - etiology; Hypocalcemia - physiopathology; identification; Incidence; incidental parathyroidectomy; Logistic Models; Male; Middle Aged; Monitoring, Intraoperative - methods; Multivariate Analysis; parathyroid gland; Parathyroid Glands - abnormalities; Parathyroid Glands - surgery; Parathyroidectomy - adverse effects; Parathyroidectomy - methods; Postoperative Complications - epidemiology; Postoperative Complications - physiopathology; Prognosis; Retrospective Studies; Risk Assessment; Sex Factors; Statistics, Nonparametric; Thyroidectomy - adverse effects; Thyroidectomy - methods; total thyroidectomy; Treatment Outcome; Young Adult; identification; total thyroidectomy; parathyroid gland; incidental parathyroidectomy; hypocalcemia
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.23613

Background The purpose of this study was to evaluate preoperative features, surgical details, and postoperative findings related to the identification of parathyroid glands and to establish the relationship between identification of parathyroid glands and postoperative hypocalcemia. Methods Seven hundred eighty‐eight total thyroidectomies performed between January 2002 and April 2012 by a single surgeon were studied. To evaluate the impact of parathyroid glands identification on study variables, patients were stratified into 2 study groups: group 1 with 0 to 2 parathyroid glands identified and group 2 with 3 to 4 parathyroid glands identified. Results Multivariate analysis identified younger age (p = .007), female sex (p = .001), and no usage of the Biclamp hemostatic technique (p < .001) related to the higher number of parathyroid glands identified. Univariate analysis revealed a higher incidence of temporary hypocalcemia (p = .015) and permanent hypoparathyroidism (p = .040) in group 2 than in group 1. Conclusion Identification of a higher number of parathyroid glands is associated with a higher incidence of postoperative temporary hypocalcemia and permanent hypoparathyroidism. © 2014 Wiley Periodicals, Inc. Head Neck 37: 393–399, 2015