title: Incidental parathyroidectomy during thyroidectomy increases the risk of postoperative hypocalcemia.
abstract: The correlation between incidental parathyroidectomy (IP) during thyroidectomy and postoperative hypocalcemia remains controversial. Our aim was to investigate the incidence of IP, risk factors, and impact on patient outcomes.
  
  
  
  Retrospective cohort study.
  
  
  
  This was a retrospective observational study including 3,186 consecutive patients who underwent thyroidectomy between January 2007 and December 2014. The patients were divided into two groups: the IP group and the non-IP. Numerous clinical parameters were collected and analyzed.
  
  
  
  The overall incidence of incidentally excised parathyroid glands during thyroidectomy was 6.4%. Patients with IP had significantly higher incidences of postoperative hypocalcemia and hypoparathyroidism than those without IP (P < 0.001). Intrathyroidal parathyroid glands presented only 2.2% of all removed parathyroid glands. Total thyroidectomy, central compartment lymph node dissection, and reoperation were independent risk factors for IP.
  
  
  
  Incidental parathyroidectomy during thyroidectomy is associated with the increased likelihood of postoperative hypocalcemia. All independent risk factors examined in the study for IP are surgery-related. Surgeons should perform meticulous dissection with the intention of avoiding IP and resultant hypocalcemia.
  
  
  
  4. Laryngoscope, 127:2194-2200, 2017.
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital Linkou Branch, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yann-Sheng
authors.initials: YS
authors.lastname: Lin
authors.affiliation: Department of Pathology, Chang Gung Memorial Hospital Linkou Branch, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chuen
authors.initials: C
authors.lastname: Hsueh
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital Linkou Branch, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Hsin-Yi
authors.initials: HY
authors.lastname: Wu
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital Linkou Branch, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ming-Chin
authors.initials: MC
authors.lastname: Yu
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital Linkou Branch, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Tzu-Chieh
authors.initials: TC
authors.lastname: Chao
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000453:epidemiology / Q000209:etiology*; D007011:Hypoparathyroidism / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D010279:Parathyroid Diseases / Q000175:diagnosis / Q000601:surgery*; D016105:Parathyroidectomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome
keywords: Incidental parathyroidectomy; central neck lymph node dissection; hypoparathyroidism; postoperative hypocalcemia; thyroidectomy