Unintentional parathyroidectomy during total thyroidectomy.
BACKGROUND
Unintentional parathyroidectomy during thyroidectomy has been evaluated in a few studies. Moreover, the impact of the surgeon's experience and operative technique has not been evaluated. Our aim was to identify the incidence of unintentional parathyroidectomy during total thyroidectomy, its clinical consequences, and factors affecting its occurrence.


METHODS
We reviewed all total thyroidectomies during a 2-year period. Patients were categorized into 2 groups: those with unintentional parathyroidectomy (parathyroidectomy group) and those without unintentional parathyroidectomy (no-parathyroidectomy group).


RESULTS
Incidental parathyroidectomy occurred in 100 (19.7%) of the 508 patients. The groups were comparable in age, thyroid weight and pathology, operative time, surgeon experience (high/low volume), operative technique (suture-ligation, LigaSure, or Ultracision), postoperative calcium, and transient hypocalcemia. No permanent hypocalcemia occurred. However, 11% of the parathyroidectomy group was men compared with 22% of the no-parathyroidectomy group (p =.002).


CONCLUSIONS
Unintentional parathyroidectomy, although common, has no clinical consequences. Unlike surgeon's experience and operative technique, patient sex was the only factor affecting its occurrence.
Manouras
Andreas
A
First Department of Propaedeutic Surgery, Hippokration Hospital, Athens Medical School, University of Athens, Athens, Greece.
Markogiannakis
Haridimos
H
Lagoudianakis
Emmanuel
E
Antonakis
Pantelis
P
Genetzakis
Michael
M
Papadima
Artemis
A
Konstantoulaki
Eleftheria
E
Papanikolaou
Dimitrios
D
Kekis
Panagiotis
P
D002983:Clinical Competence; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012189:Retrospective Studies; D017678:Sex Distribution; D013965:Thyroidectomy