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Langenbeck's Archives of Surgery

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01-12-2023 | Hypoparathyroidism | Research

Accidental parathyroidectomy during total thyroidectomy and hypoparathyroidism in a large series of 766 patients: incidence and consequences in a referral center

Authors: Nunzia Cinzia Paladino, Hanna Remde, Carole Guerin, Isabelle Morange, David Taïeb, Frédéric Sebag

Published in: Langenbeck's Archives of Surgery | Issue 1/2023

Abstract

Purpose

Transient hypoparathyroidism is the most common complication after total thyroidectomy, and accidental parathyroidectomy (AP) may be a cause. The aim of this study was to investigate the incidence of AP and its impact on postoperative calcemia.

Materials and methods

From February 2016 to May 2018, 766 patients undergoing total thyroidectomy were prospectively included. Surgical indications, hormonal status, definitive histology, and postoperative calcium and PTH levels were analyzed.

Results

578/(75.45%) were women and 188/(24.55%) men with mean age of 53.4 years. Parathyroid tissue on the thyroid specimen was observed in 40 (5.2%) patients: 30 APs and 10 parathyroid fragments. Among the 30 APs, 12 glands were intrathyroid and 18 (2.3%) in eutopic location. 97 (12.6%) patients were treated for postoperative hypocalcemia: 90 (11.7%) had transient and 5 (0.6%) definitive hypoparathyroidism; 2 were lost in follow-up. 13/30 (43.3%) with AP had transient hypoparathyroidism. A strong correlation was found (p < 0.0001) between AP and postoperative hypocalcemia. 1/30 (3.3%) patient with APs had definitive hypoparathyroidism. Transient and persistent nerve palsies were found in 10 (1.3%) and 3 (0.4%) patients, respectively.

Discussion

A careful examination of the thyroid gland after resection help to identify an AP that could be autotransplanted. Surgeon and hospital activity volume per years seem to reduce the risk of hypoparathyroidism.

Conclusion

Total thyroidectomy and intrathyroid localization of parathyroid glands are risk factors for the AP. The incidence of AP was 2.3%, and this remains low due to our longstanding experience in thyroid and parathyroid surgery.

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Title: Accidental parathyroidectomy during total thyroidectomy and hypoparathyroidism in a large series of 766 patients: incidence and consequences in a referral center
Authors: Nunzia Cinzia Paladino
Hanna Remde
Carole Guerin
Isabelle Morange
David Taïeb
Frédéric Sebag
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Hypoparathyroidism
Thyroidectomy
Thyroidectomy
Hypocalcemia
Parathyroidectomy
Parathyroidectomy
Hyperthyroidism
Thyroid and Parathyroid Surgery
Thyroid and Parathyroid Surgery
Published in: Langenbeck's Archives of Surgery / Issue 1/2023
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-023-03130-w

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Accidental parathyroidectomy during total thyroidectomy and hypoparathyroidism in a large series of 766 patients: incidence and consequences in a referral center

Abstract

Purpose

Materials and methods

Results

Discussion

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Discussion

Conclusion

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