Assessment of risk factors of incidental parathyroidectomy during thyroid surgery: a prospective study.

Objectives: To determine the incidence, risk factors and clinical relevance of incidental parathyroidectomy during thyroidectomy.

Methods: A total of 207 consecutive patients with benign and malignant thyroid disorders undergoing unilateral or bilateral thyroidectomy were included prospectively in the present study. Patients were divided into two groups according to incidental parathyroidectomy.

Results: Two hundred and ten thyroidectomies were performed. Group A included 26 patients with incidental parathyroidectomy and group B included 181 patients without incidental parathyroidectomy. The parathyroid tissue in the resected specimens was found in intrathyroid (57.7%), extrathyroid (23.1%) and central node compartment (19.2%) sites. On multivariate analysis, two factors sustained their significance independently; reoperation for recurrent goitre (p=0.001) and concomitant central neck dissection (p=0.001). There was no statistically significant difference regarding the occurrence of postoperative hypocalcemia between the two groups (p=0.55).

Conclusion: Reoperation for recurrent goitre and concomitant central neck dissection for cancer thyroid may increase the risk of incidental parathyroidectomy. Incidental parathyroidectomy is not associated with symptomatic postoperative hypocalcemia. Most of removed parathyroid glands were intrathyroid, so incidental parathyroidectomy may be unavoidable.