Department of Surgery, Mansoura University Hospital, Mansoura, Egypt.
Int J Surg. 2010;8(3):207-11. doi: 10.1016/j.ijsu.2009.12.008. Epub 2010 Jan 11.
To determine the incidence, risk factors and clinical relevance of incidental parathyroidectomy during thyroidectomy.
A total of 207 consecutive patients with benign and malignant thyroid disorders undergoing unilateral or bilateral thyroidectomy were included prospectively in the present study. Patients were divided into two groups according to incidental parathyroidectomy.
Two hundred and ten thyroidectomies were performed. Group A included 26 patients with incidental parathyroidectomy and group B included 181 patients without incidental parathyroidectomy. The parathyroid tissue in the resected specimens was found in intrathyroid (57.7%), extrathyroid (23.1%) and central node compartment (19.2%) sites. On multivariate analysis, two factors sustained their significance independently; reoperation for recurrent goitre (p=0.001) and concomitant central neck dissection (p=0.001). There was no statistically significant difference regarding the occurrence of postoperative hypocalcemia between the two groups (p=0.55).
Reoperation for recurrent goitre and concomitant central neck dissection for cancer thyroid may increase the risk of incidental parathyroidectomy. Incidental parathyroidectomy is not associated with symptomatic postoperative hypocalcemia. Most of removed parathyroid glands were intrathyroid, so incidental parathyroidectomy may be unavoidable.
确定甲状腺切除术时偶然甲状旁腺切除术的发生率、风险因素和临床相关性。
本前瞻性研究共纳入 207 例接受单侧或双侧甲状腺切除术的良性和恶性甲状腺疾病患者。根据偶然甲状旁腺切除术将患者分为两组。
共进行了 210 例甲状腺切除术。A 组包括 26 例偶然甲状旁腺切除术患者，B 组包括 181 例无偶然甲状旁腺切除术患者。切除标本中的甲状旁腺组织位于甲状腺内（57.7%）、甲状腺外（23.1%）和中央淋巴结隔室（19.2%）。多因素分析显示，有两个因素独立具有重要意义；复发性甲状腺肿的再次手术（p=0.001）和中央颈部淋巴结清扫术（p=0.001）。两组术后低钙血症的发生无统计学差异（p=0.55）。
复发性甲状腺肿的再次手术和甲状腺癌的中央颈部淋巴结清扫术可能增加偶然甲状旁腺切除术的风险。偶然甲状旁腺切除术与术后症状性低钙血症无关。大多数切除的甲状旁腺位于甲状腺内，因此偶然甲状旁腺切除术可能是不可避免的。
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