Dissection and identification of parathyroid glands during thyroidectomy: association with hypocalcemia.
BACKGROUND
The purpose of this study was to evaluate preoperative features, surgical details, and postoperative findings related to the identification of parathyroid glands and to establish the relationship between identification of parathyroid glands and postoperative hypocalcemia.


METHODS
Seven hundred eighty-eight total thyroidectomies performed between January 2002 and April 2012 by a single surgeon were studied. To evaluate the impact of parathyroid glands identification on study variables, patients were stratified into 2 study groups: group 1 with 0 to 2 parathyroid glands identified and group 2 with 3 to 4 parathyroid glands identified.


RESULTS
Multivariate analysis identified younger age (p = .007), female sex (p = .001), and no usage of the Biclamp hemostatic technique (p < .001) related to the higher number of parathyroid glands identified. Univariate analysis revealed a higher incidence of temporary hypocalcemia (p = .015) and permanent hypoparathyroidism (p = .040) in group 2 than in group 1.


CONCLUSIONS
Identification of a higher number of parathyroid glands is associated with a higher incidence of postoperative temporary hypocalcemia and permanent hypoparathyroidism.
Department of Otolaryngology, Third Medical Faculty of the Charles University, Military University Hospital, Prague, The Czech Republic; Department of Otolaryngology, Midland Regional Hospital, Tullamore, Ireland.
Pavol
P
Praženica
Leonard
L
O'Keeffe
Richard
R
Holý
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015331:Cohort Studies; D004210:Dissection; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology / Q000503:physiopathology*; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D015999:Multivariate Analysis; D010280:Parathyroid Glands / Q000002:abnormalities / Q000601:surgery*; D016105:Parathyroidectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
hypocalcemia; identification; incidental parathyroidectomy; parathyroid gland; total thyroidectomy