The risk factors and incidence of hypocalcemia in unintentional parathyroid gland removal during thyroid surgical interventions
To identify the risk factors and incidence of hypocalcemia in unintentional parathyroid gland removal during thyroid surgical interventions
PATIENTS AND METHODS:
Retrospective study of 2 years conducted at JPMC from April 2016 – April 2018
Total number of patients were 86 patients, female were 53 and males were 33. In 1st year of study, 28 cases were benign and 10 cases were malignant. In 2nd year 34 patients pathology were benign and 14 were malignant where all the benign lesions of thyroid, in 62 cases lobectomies was done and rest of 24 malignant cases completion thyroidectomy/total thyroidectomy with central neck/ modified neck dissection were performed.
24 cases from total of 86 were malignant, which were treated accordingly resulting in temporary hypocalcemia in 07 cases. 06 Cases of Papillary Ca (Total thyroidectomy with central neck Dissection) resulted in temporary hypocalcemia in 02 cases.
07 Multinodular goiter (Total thyroidectomy) resulted in temporary hypocalcemia in 02 cases
In 08 Cases lobectomies/ FNAC was done initially but then their histopathological reports turned out as Papillary Ca where completion thyroidectomy with central neck dissection was performed in 07 cases and total thyroidectomy with modified neck dissection in 01 case which resulted in temporary hypocalcemia in 03 cases
03 cases of Follicular Ca in which Total thyroidectomy was performed resulted in no cases of temporary hypocalcemia.
Re-operated surgeries, malignant thyroid pathology with neck dissection (central/ modified neck dissection) are associated with high chances of unintentional parathyroid gland removal, as it has clinical consequences the operating surgeon should consider these risk factors during recurrent malignant surgery with neck dissection.