Publication:

Assessment between hypoparathyroidism and the number of parathyroid glands preserved during thyroidectomy: a record based study

Background Hypoparathyroidism is a major complication of thyroidectomy. The association between the number of parathyroid glands preserved and hypoparathyroidism is not well understood. The objectives of the study were to evaluate the clinical characteristics and the frequency of hypoparathyroidism during thyroidectomy, and to determine the minimum number of parathyroid glands that need to be preserved to prevent hypoparathyroidism.

Methods A retrospective study was conducted in Department of Surgery in Tertiary care hospital from January 2016 to December 2017. Around 250 patients who underwent total thyroidectomy for papillary thyroid carcinoma were analysed. We evaluated the frequency of hypoparathyroidism according to the number of parathyroid glands preserved.

Results Incidental parathyroidectomy occurred in 20% of the patients; one parathyroid gland in 16%, two in 1.5%, and three in 0.9%. Transient hypoparathyroidism was increased when incidental parathyroidectomy occurred (odds ratio 1.63, 95% confidence interval 1.07 to 3.13, p=0.03). There was no significant relationship between the number of parathyroid glands preserved and permanent hypoparathyroidism (p=0.16).

Conclusions Conservation of all parathyroid glands decreases transient hypoparathyroidism equated with when three or fewer glands are preserved but does not affect permanent hypoparathyroidism.