Endocrine Surgery Unit, Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Department of Pathology, Directorate of Laboratory Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
J Laryngol Otol. 2023 Nov;137(11):1226-1232. doi: 10.1017/S002221512300035X. Epub 2023 Mar 6.
To evaluate the incidence of inadvertent parathyroidectomy, identify risk factors, determine the location of inadvertently excised glands, review pathology reporting in inadvertent parathyroidectomy, and explore relationships between inadvertent parathyroidectomy and post-surgical hypoparathyroidism or hypocalcaemia.
A retrospective cohort study of 899 thyroidectomies between 2015 and 2020 was performed. Histopathology slides of patients who had an inadvertent parathyroidectomy and a random sample of patients without a reported inadvertent parathyroidectomy were reviewed.
Inadvertent parathyroidectomy occurred in 18.5 per cent of thyroidectomy patients. Central neck dissection was an independent risk factor (inadvertent parathyroidectomy = 49.4 per cent with central neck dissection, 12.0 per cent without central neck dissection, < 0.001). Most excised parathyroid glands were extracapsular (53.3 per cent), followed by subcapsular (29.1 per cent) and intrathyroidal (10.9 per cent). Parathyroid tissue was found in 10.2 per cent of specimens where no inadvertent parathyroidectomy was reported. Inadvertent parathyroidectomy was associated with a higher incidence of six-month post-surgical hypoparathyroidism or hypocalcaemia (19.8 per cent who had an inadvertent parathyroidectomy, 7.7 per cent without inadvertent parathyroidectomy).
Inadvertent parathyroidectomy increases the risk of post-surgical hypoparathyroidism or hypocalcaemia. The proportion of extracapsular glands contributing to inadvertent parathyroidectomy highlights the need for preventative measures.
评估甲状旁腺意外切除的发生率，确定风险因素，确定意外切除腺体的位置，回顾甲状旁腺意外切除的病理报告，并探讨甲状旁腺意外切除与术后甲状旁腺功能减退或低钙血症之间的关系。
对 2015 年至 2020 年间进行的 899 例甲状腺切除术进行回顾性队列研究。对甲状旁腺意外切除患者的组织病理学切片和未报告甲状旁腺意外切除的随机样本患者的组织病理学切片进行了回顾。
甲状旁腺意外切除发生在 18.5%的甲状腺切除术患者中。中央颈部解剖是一个独立的危险因素（甲状旁腺意外切除=49.4%有中央颈部解剖，12.0%无中央颈部解剖，<0.001）。大多数切除的甲状旁腺位于包膜外（53.3%），其次是包膜下（29.1%）和甲状腺内（10.9%）。在未报告甲状旁腺意外切除的 10.2%的标本中发现了甲状旁腺组织。甲状旁腺意外切除与术后 6 个月甲状旁腺功能减退或低钙血症的发生率较高相关（甲状旁腺意外切除 19.8%，无甲状旁腺意外切除 7.7%）。
甲状旁腺意外切除增加了术后甲状旁腺功能减退或低钙血症的风险。包膜外腺体在甲状旁腺意外切除中的比例突出了预防措施的必要性。
