Background: The most important factors affecting the development of postoperative hypocalcaemia (PH) include intraoperative trauma to the parathyroid glands, incidental parathyroidectomy (IP), and the surgeon's experience. In this study, we aimed to determine the incidence of IP, evaluate its effect on postoperative calcium levels and investigate the effect of surgeon experience and volume on IP incidence and postoperative calcium levels.
Methods: This retrospective study included 645 patients who underwent thyroid surgery at the Department of General Surgery, Kütahya Health Sciences University between September 2016 and March 2020. All patients underwent surgery at a single clinic by general surgeons experienced in thyroid surgery and their residents (3-5 years).
Results: Normal parathyroid glands were reported in 58 (8.9%) of 645 patients. In 5 (8.6%) of 58 patients the parathyroid gland was detected in the intrathyroidal region. PH developed in ten patients (17.2%) with incidental removal of the parathyroid glands. A statistically significant difference was found between the number of incidentally removed parathyroid glands and the development of hypocalcaemia (<0.05). Normal parathyroid glands were reported in the pathology of 37 (7.9%) patients operated on by general surgeons and 22 (12.6%) patients operated on by their residents. PH developed in 39 (8.2%) patients operated on by general surgeons and in 8 (4.5%) patients operated on by their residents.
Conclusions: We found that the complication rate during the resident training process was the same as that of experienced general surgeons. A thyroidectomy can be safely performed by senior residents during residential training.
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http://dx.doi.org/10.1308/rcsann.2024.0019 | DOI Listing |
Updates Surg
January 2025
Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy.
Background: Recently, several devices exploiting the near-infrared autofluorescence (NIR-AF) of parathyroid glands (PGs) have been developed. Nevertheless, their impact on both preserving PGs from inadvertent surgical dissection and on post-surgical hypoparathyroidism (hypoPTH) is controversial.
Methods: A retrospective study of 845 patients undergoing thyroid surgery in 2 academic tertiary centres was conducted.
Am J Surg
January 2025
Department of Endocrine Surgery, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia; Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Introduction: Permanent hypoparathyroidism (pHypoPT) is the most common permanent complication of total thyroidectomy. We aim to describe the incidence and predictors of hypoparathyroidism in a consecutive series of patients treated in a high-volume centre and define strategies to reduce the risk of pHypoPT.
Methods: 1182 patients who underwent total thyroidectomy between April 2018 and June 2022 were analyzed.
Adv Exp Med Biol
January 2025
Institute of Biotechnology, Helsinki Institute of Life Science HiLIFE, University of Helsinki, Helsinki, Finland.
Embryonic mammary gland development unfolds with the specification of bilateral mammary lines, thereafter progressing through placode, bud, and sprout stages before branching morphogenesis. Extensive epithelial-mesenchymal interactions guide morphogenesis from embryogenesis to adulthood. Two distinct mesenchymal tissues are involved, the primary mammary mesenchyme that harbors mammary inductive capacity, and the secondary mesenchyme, the precursor of the adult stroma.
View Article and Find Full Text PDFAnn Endocrinol (Paris)
January 2025
Department of Endocrinology Diabetes Nutrition, Hôpital Robert-Debré, CHU de Reims, F-51100 Reims, France. Electronic address:
Persistent primary hyperparathyroidism is defined as the persistence or recurrence of hypercalcemia within 6 months of parathyroid surgery. Recurrent primary hyperparathyroidism is defined as the recurrence of primary hyperparathyroidism more than 6 months after an initially curative parathyroidectomy. In these situations, it is essential to rule out differential diagnoses, and in particular secondary hyperparathyroidism and familial hypocalciuric hypercalcemia.
View Article and Find Full Text PDFAnn Endocrinol (Paris)
January 2025
Endocrinology Federation, Hôpital Louis Pradel, 28 Avenue doyen Lépine, 69500 Bron, Hospices Civils de Lyon and Université Lyon 1, France. Electronic address:
In over 80% of cases, primary hyperparathyroidism results from hypersecretion of PTH by a single parathyroid adenoma. Multi-glandular involvement, combining adenoma and/or hyperplasia in varying proportions, is also possible, although less frequent. When the diagnosis of hyperparathyroidism is certain and surgery is envisaged, imaging is useful for locating the hyperfunctioning gland or glands.
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