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甲状腺手术中意外甲状旁腺切除的危险因素

Risk Factors of Incidental Parathyroidecomy in Thyroid Surgery.

作者信息

Alraddadi Thamer, Aldhahri Saleh, Almayouf Mohammad, Alharbi Jabir, Malas Moayyad, Nasrullah Muhammad, Al-Qahtani Khalid

机构信息

Otolaryngology, King Saud University, Riyadh, SAU.

Otolaryngology, Head & Neck Surgery, King Saud University, Riyadh, SAU.

出版信息

Cureus. 2019 Dec 30;11(12):e6517. doi: 10.7759/cureus.6517.

Abstract

BACKGROUND

Incidental parathyroidectomy with subsequent hypoparathyroidism and postoperative hypocalcemia is thought to be one of the common complications of thyroidectomy. Current literature reports wide discrepancy in incidence and risk factors.

OBJECTIVES

The aim of our study was to evaluate the incidence and risk factors of incidental parathyroidectomy in thyroid surgery.

METHODS

A retrospective study included 270 patients who had thyroid surgery that was performed over two years from January 2017 to December 2018 in two tertiary care hospitals. Preoperative and postoperative records were assessed. Factors such as gender, diagnosis, type of surgery, and usage of surgical loupes during the procedure were evaluated and were compared to find the association with incidental parathyroidectomy in thyroid surgery.

RESULTS

Incidental parathyroidectomy was noticed in 62 (23%) surgical specimens during histopathologic examination. There was no significant association between incidental parathyroidectomy and sex of patient, use of surgical loupes, pathology of thyroid disease, or neck dissection.

CONCLUSION

Although the risk of incidental parathyroidectomy is inevitable, careful dissection and meticulous intraoperative identification of parathyroid gland during thyroidectomy can reduce the incidence of incidental parathyroidectomy, thereby minimizing the risk of postoperative hypoparathyroidism and hypocalcemia.

摘要

背景

甲状腺切除术中意外甲状旁腺切除及随后的甲状旁腺功能减退和术后低钙血症被认为是甲状腺切除术常见的并发症之一。目前的文献报道在发病率和危险因素方面存在很大差异。

目的

我们研究的目的是评估甲状腺手术中意外甲状旁腺切除的发病率和危险因素。

方法

一项回顾性研究纳入了2017年1月至2018年12月在两家三级医疗医院进行的为期两年的270例甲状腺手术患者。评估术前和术后记录。对性别、诊断、手术类型以及手术过程中手术放大镜的使用等因素进行评估,并进行比较以找出与甲状腺手术中意外甲状旁腺切除的关联。

结果

在组织病理学检查中,62例(23%)手术标本中发现意外甲状旁腺切除。意外甲状旁腺切除与患者性别、手术放大镜的使用、甲状腺疾病的病理或颈部清扫之间无显著关联。

结论

尽管意外甲状旁腺切除的风险不可避免,但在甲状腺切除术中仔细解剖并在术中仔细识别甲状旁腺可以降低意外甲状旁腺切除的发生率,从而将术后甲状旁腺功能减退和低钙血症的风险降至最低。

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