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Unintentional parathyroidectomy during total thyroidectomy surgery: A single surgeon's experience

In this study, we investigated incidental parathyroidectomy during total thyroidectomy surgery that required central lymph node dissection and the potential risk factors. Patients requiring total thyroidectomy and tracheoesophageal groove node dissection were enrolled in the study from January 2013...

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Autores principales: Du, Wei, Fang, Qigen, Zhang, Xu, Cui, Meng, Zhao, Ming, Lou, Weihua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369942/
https://www.ncbi.nlm.nih.gov/pubmed/28296787
http://dx.doi.org/10.1097/MD.0000000000006411
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author Du, Wei
Fang, Qigen
Zhang, Xu
Cui, Meng
Zhao, Ming
Lou, Weihua
author_facet Du, Wei
Fang, Qigen
Zhang, Xu
Cui, Meng
Zhao, Ming
Lou, Weihua
author_sort Du, Wei
collection PubMed
description In this study, we investigated incidental parathyroidectomy during total thyroidectomy surgery that required central lymph node dissection and the potential risk factors. Patients requiring total thyroidectomy and tracheoesophageal groove node dissection were enrolled in the study from January 2013 to June 2015 and we obtained all medical information, including pathology reports. Furthermore, we recorded the parathyroid hormone level in all patients prior to operation and then 3 further times: 1 day, 1 week, and 3 months after surgery. A total of 341 patients (66 male and 275 female) were enrolled in the study. Microscopic examination of postoperative specimens revealed that incidental parathyroidectomy existed in 35 (10.3%) cases: 32 (91.4%) patients had 1 parathyroid gland excised, 3 (8.6%) patients had 2 parathyroid glands excised, and no patients had 3 or more parathyroid glands resected. The mean size of the resected glands was 4.6 mm. Parathyroid tissue from 16 (42.1%) cases was located in the intrathyroidal position, 6 glands were located in central lymphatic adipose tissue, and 16 glands were located within or along with thymus tissue. Lateral neck dissection significantly increased the risk of incidental parathyroidectomy (P < 0.001). No other factors including age, sex, and postoperative symptomatic hypocalcemia were significantly associated with incidental parathyroidectomy (all P > 0.05), though incidental parathyroidectomy tended to cause transient hypoparathyroidism (P = 0.051). Therefore, the risk of incidental parathyroidectomy in total thyroidectomy is relatively low; the majority of the resected parathyroid tissue is situated outside the thyroid, therefore we suggest future operations focus on preserving the parathyroid gland when the node dissection is close to the thymus. Incidental parathyroidectomy appears to have an effect on the expression of parathyroid hormone and it is significantly associated with lateral cervical lymph node dissection.
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spelling pubmed-53699422017-03-31 Unintentional parathyroidectomy during total thyroidectomy surgery: A single surgeon's experience Du, Wei Fang, Qigen Zhang, Xu Cui, Meng Zhao, Ming Lou, Weihua Medicine (Baltimore) 7100 In this study, we investigated incidental parathyroidectomy during total thyroidectomy surgery that required central lymph node dissection and the potential risk factors. Patients requiring total thyroidectomy and tracheoesophageal groove node dissection were enrolled in the study from January 2013 to June 2015 and we obtained all medical information, including pathology reports. Furthermore, we recorded the parathyroid hormone level in all patients prior to operation and then 3 further times: 1 day, 1 week, and 3 months after surgery. A total of 341 patients (66 male and 275 female) were enrolled in the study. Microscopic examination of postoperative specimens revealed that incidental parathyroidectomy existed in 35 (10.3%) cases: 32 (91.4%) patients had 1 parathyroid gland excised, 3 (8.6%) patients had 2 parathyroid glands excised, and no patients had 3 or more parathyroid glands resected. The mean size of the resected glands was 4.6 mm. Parathyroid tissue from 16 (42.1%) cases was located in the intrathyroidal position, 6 glands were located in central lymphatic adipose tissue, and 16 glands were located within or along with thymus tissue. Lateral neck dissection significantly increased the risk of incidental parathyroidectomy (P < 0.001). No other factors including age, sex, and postoperative symptomatic hypocalcemia were significantly associated with incidental parathyroidectomy (all P > 0.05), though incidental parathyroidectomy tended to cause transient hypoparathyroidism (P = 0.051). Therefore, the risk of incidental parathyroidectomy in total thyroidectomy is relatively low; the majority of the resected parathyroid tissue is situated outside the thyroid, therefore we suggest future operations focus on preserving the parathyroid gland when the node dissection is close to the thymus. Incidental parathyroidectomy appears to have an effect on the expression of parathyroid hormone and it is significantly associated with lateral cervical lymph node dissection. Wolters Kluwer Health 2017-03-24 /pmc/articles/PMC5369942/ /pubmed/28296787 http://dx.doi.org/10.1097/MD.0000000000006411 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 7100
Du, Wei
Fang, Qigen
Zhang, Xu
Cui, Meng
Zhao, Ming
Lou, Weihua
Unintentional parathyroidectomy during total thyroidectomy surgery: A single surgeon's experience
title Unintentional parathyroidectomy during total thyroidectomy surgery: A single surgeon's experience
title_full Unintentional parathyroidectomy during total thyroidectomy surgery: A single surgeon's experience
title_fullStr Unintentional parathyroidectomy during total thyroidectomy surgery: A single surgeon's experience
title_full_unstemmed Unintentional parathyroidectomy during total thyroidectomy surgery: A single surgeon's experience
title_short Unintentional parathyroidectomy during total thyroidectomy surgery: A single surgeon's experience
title_sort unintentional parathyroidectomy during total thyroidectomy surgery: a single surgeon's experience
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369942/
https://www.ncbi.nlm.nih.gov/pubmed/28296787
http://dx.doi.org/10.1097/MD.0000000000006411
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