Department of Breast and Endocrine Surgery, Ankara City Hospital, Ankara, Turkey.
Department of General Surgery, Ankara City Hospital, Ankara, Turkey.
Acta Chir Belg. 2021 Feb;121(1):36-41. doi: 10.1080/00015458.2020.1828677. Epub 2020 Oct 6.
This study aims to determine the frequency of incidental parathyroidectomy (IP), to reveal the risk factors and to present the clinical importance of IP through the experiences of our clinic.
Patients undergoing thyroid surgery between June 2016 and May 2019 were reviewed retrospectively. Along with demographic data, surgery reports, pathology results and postoperative follow-up data were examined. Factors assumed to be associated with IP and postoperative hypocalcemia were compared between the IP group and the non-IP group.
A total of 633 patients with a mean age of 48 ± 13 years were included in this study. IP was detected in 138 (21.8%) patients and parathyroid glands were localized 29.72% intrathyroidal. Postoperative hypocalcemia in the IP group was approximately 2-fold higher than the no-IP group (%15.94 to %7.27), ( < .001). Gender ( = .014), body mass index ( = .021), both preoperative and postoperative diagnosis of malignancy ( < .001) and performing central neck dissection (CND) ( < .001) were significantly associated with IP in univariate analysis. However, multivariate analysis demonstrated that CND was independently associated with IP (OR = 0.301, 95% Cl: 0.161-0.562, < .001).
This study reveals that IP increases the frequency of postoperative temporary and permanent hypocalcemia in patients undergoing thyroid surgery, and CND is the only independent risk factor for IP. Highlights of the study This study reveals that central neck dissection is the most important and only independent risk factor for incidental parathyroidectomy in patients undergoing thyroid surgery. According to our analysis, both temporary and permanent hypocalcemia, which occurs in the postoperative period, are associated with incidental parathyroidectomy.
本研究旨在确定偶然甲状旁腺切除术（IP）的频率，揭示其风险因素，并通过我们的临床经验阐述 IP 的临床重要性。
回顾性分析 2016 年 6 月至 2019 年 5 月期间接受甲状腺手术的患者。检查了人口统计学数据、手术报告、病理结果和术后随访数据。比较了 IP 组和非 IP 组中与 IP 相关的假设因素和术后低钙血症。
本研究共纳入 633 例平均年龄为 48±13 岁的患者。在 138 例患者（21.8%）中发现了 IP，甲状旁腺 29.72%位于甲状腺内。IP 组术后低钙血症的发生率明显高于非 IP 组（15.94%比 7.27%， < .001）。单因素分析显示，性别（ = .014）、体重指数（ = .021）、术前和术后均诊断为恶性肿瘤（ < .001）和行中央颈部清扫术（CND）（ < .001）与 IP 显著相关。然而，多因素分析表明 CND 与 IP 独立相关（OR=0.301，95%CI：0.161-0.562， < .001）。
本研究表明，IP 增加了甲状腺手术后患者暂时性和永久性低钙血症的发生频率，而 CND 是 IP 的唯一独立危险因素。
本研究表明，在接受甲状腺手术的患者中，中央颈部清扫术是偶然甲状旁腺切除术最重要和唯一的独立危险因素。根据我们的分析，术后发生的暂时性和永久性低钙血症均与偶然甲状旁腺切除术有关。
