title: Incidental parathyroidectomy during thyroid resection: incidence, risk factors, and outcome.
abstract: OBJECTIVE
  Thyroidectomy is a commonly performed procedure for thyroid problems. Inadvertent removal of the parathyroid glands is one of its recognized complications, which occurs more frequently in certain high-risk patients. The aim of this study was to identify the incidence, risk factors, and clinical relevance of incidental parathyroidectomy during thyroid surgery.
  
  
  METHODS
  A retrospective review of thyroid operations performed at a tertiary referral hospital between January 2004 and December 2008.
  
  
  METHODS
  Pathology reports were reviewed to identify the specimens that included parathyroid tissue and underlying thyroid pathology. Postoperative calcium levels were reviewed in these patients.
  
  
  RESULTS
  During the study period, 287 thyroidectomies were performed and 47 (16.4%) patients had incidentally removed parathyroid glands. Risk factors for inadvertent parathyroid resection included total thyroidectomy (P=.0001), Hashimoto thyroiditis (P=.004), and extrathyroidal spread (P=.0003). Postoperative hypocalcemia occurred in 18 (38.3%) of the patients in whom the parathyroid gland was removed inadvertently and in 48 (20%) of the rest of the patients (P=.0123).
  
  
  CONCLUSIONS
  The incidence of incidental removal of parathyroid tissue during thyroidectomy is 16.4%. Total thyroidectomy, extrathyroidal extension of the tumor, and thyroiditis were found to be the risk factors. Hypocalcemia was significantly higher among patients who had inadvertent parathyroidectomy.
authors.affiliation: Department of Surgery, Division of General Surgery, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia. drgamalk@gmail.com
authors.forename: Gamal Ahmed
authors.initials: GA
authors.lastname: Khairy
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: Al-Saif
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology; D015994:Incidence; D007431:Intraoperative Complications; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D016105:Parathyroidectomy / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D013959:Thyroid Diseases / Q000503:physiopathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D002118:Calcium