• Published
    18-01-2024
  • Issue
    Vol: 28 Issue: 01, 2024
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THE NEXUS OF UNINTENTIONAL PARATHYROIDECTOMY, HYPOPARATHYROIDISM, AND POSTOPERATIVE PTH MONITORING IN THYROID SURGERY-A RECORD BASED STUDY

  • Dr.Tony Mathew , Mr.Jim Job, Dr.Naveen George, Dr.Obed Manuel Kuruvilla, Dr.A.S Mathew, Dr.Asha Thankam Abraham

Keywords:-Parathyroid, Hypocalcaemia, Hypoparathyroidism, Thyroidectomy

ABSTRACT:-
Background- Hypoparathyroidism stands as a significant side effect following thyroidectomy. Yet, the potential correlation between hypoparathyroidism and the quantity of preserved parathyroid glands remains unclear. Objectives- To assess the incidence of Unintentional Parathyroidectomy (UIP) and its correlation with hypoparathyroidism and to determine the essential minimum number of preserved parathyroid glands to prevent its occurrence. Methods- From October 2022 to September 2023, a retrospective analysis was performed at the surgery department of a tertiary care teaching hospital. Using a purposeful sampling method, around 250 individuals who underwent thyroidectomy were selected. The study excluded patients with severe chronic renal insufficiency, those who underwent parathyroid gland auto-transplantation, individuals with a history of neck irradiation, and cases of thyroidectomy in patients with primary hyperparathyroidism. Prior to participation, written informed consent was obtained from all subjects, and the institutional ethics committee approved the study. Results- Unintentional Parathyroidectomy occurred in 18.4% of the patients; one parathyroid gland in 16%, two in 1.5%, and three in 0.9%. Transient hypoparathyroidism was increased when Unintentional Parathyroidectomy (UIP) occurred. There was no significant relationship between the number of parathyroid glands preserved and permanent hypoparathyroidism (P= 0.16). Conclusions- preserving at least one functional parathyroid gland is crucial in averting post-thyroid surgery hypoparathyroidism. Furthermore, vigilant postoperative monitoring of parathyroid hormone levels stands as a critical measure for early detection and tailored intervention strategies, particularly for at-risk patients.