Özden Sabri, Erdoğan Ahmet, Simsek Besir, Saylam Baris, Yıldız Baris, Tez Mesut
Department of Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.
Department of Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
Auris Nasus Larynx. 2018 Jun;45(3):574-577. doi: 10.1016/j.anl.2017.07.019. Epub 2017 Aug 12.
Thyroidectomy is a very common surgical procedure. Regardless of surgeon experience, incidental parathyroidectomy is a complication of thyroidectomy. The aim of this study was to identify the clinical course of incidental parathyroidectomies after thyroidectomy.
Patients who underwent thyroidectomy between January 2010 and June 2014 were evaluated retrospectively. Pathology reports were reviewed for the presence of parathyroid tissue in the thyroidectomy pathology specimens. Information regarding demographic, laboratory variables, operative details, and postoperative complications were collected.
Incidental parathyroidectomy was found in 178 out of 3022 patients who had thyroidectomy (5.8%). Types of surgeries performed for 178 patients were total thyroidectomy (TT) in 132(74.2%) cases, TT and central lymph node dissection(CLND) in 30 (16.9%) cases, lobectomy in seven cases (3.9%), completion thyroidectomy in five (2.8%) patients and modified cervical lymph node dissection in four (2.2%)patients. One and two parathyroid glands were accidentally removed in 152 (85.3%) and 26 (14.7%) patients, respectively. In the entire series, biochemical temporary postoperative hypocalcemia occurred in 75(42.1%) patients and permanent hypocalcemia occured in 12 (6.7%) patients with incidental parathyroidectomy. There was not a statistically significant difference regarding the occurrence of postoperative permanent hypocalcemia between the patients who had incidental parathyroidectomy of one gland and the patients with two incidental parathyroidectomies (p=0.114).
Incidental parathyroidectomy is not uncommon during thyroidectomy. No association between inadvertent parathyroidectomy and postoperative permanent hypocalcemia was found.
甲状腺切除术是一种非常常见的外科手术。无论外科医生的经验如何，意外甲状旁腺切除术都是甲状腺切除术的一种并发症。本研究的目的是确定甲状腺切除术后意外甲状旁腺切除术的临床过程。
对2010年1月至2014年6月期间接受甲状腺切除术的患者进行回顾性评估。审查病理报告，以确定甲状腺切除病理标本中是否存在甲状旁腺组织。收集有关人口统计学、实验室变量、手术细节和术后并发症的信息。
在3022例接受甲状腺切除术的患者中，有178例（5.8%）发现意外甲状旁腺切除术。178例患者所进行的手术类型为：全甲状腺切除术（TT）132例（74.2%），TT加中央淋巴结清扫术（CLND）30例（16.9%），叶切除术7例（3.9%），甲状腺次全切除术5例（2.8%），改良颈淋巴结清扫术4例（2.2%）。分别有152例（85.3%）和26例（14.7%）患者意外切除了1个和2个甲状旁腺。在整个系列中，75例（42.1%）意外甲状旁腺切除术患者术后发生生化性暂时性低钙血症，12例（6.7%）发生永久性低钙血症。意外切除1个甲状旁腺的患者与意外切除2个甲状旁腺的患者术后永久性低钙血症的发生率无统计学显著差异（p=0.114）。
甲状腺切除术中意外甲状旁腺切除术并不少见。未发现意外甲状旁腺切除术与术后永久性低钙血症之间存在关联。
