Hurtamina Khan.
Risk Factors and Frequency of Hypocalcaemia in Unintentional Parathyroid Gland Removal During Thyroid Surgical Interventions.
Ann Jinnah Sindh Med Uni Jan ;5(1):35-8.

ABSTRACT Objectives: To identify the risk factors and to determine the frequency of hypocalcaemia in unintentional parathyroid gland removal during thyroid surgical interventions at a tertiary care hospital in Karachi Methodology: Retrospective study of two years was conducted at Jinnah Postgraduate Medical Centre (JPMC), Karachi from April 2016 to April 2018. The Head & Neck departments records were accessed and analyzed using a proforma. Results: Total 86 patients were identified. Twenty-four (24) cases from the total of 86 were found to be malignant, which were treated accordingly, resulting in temporary hypocalcaemia in seven (7) cases. Six (6) Cases of Papillary Ca (total thyroidectomy with central neck dissection) resulted in temporary hypocalcaemia in two (2) cases. Seven (7) multinodular goiter (total thyroidectomy) resulted in temporary hypocalcaemia in two (2) cases. In eight (8) cases, lobectomies/ FNAC was done initially, but then their histopathological reports turned out as Papillary Ca. Therefore, completion thyroidectomy with central neck dissection was performed in seven (7) cases and total thyroidectomy with modified neck dissection in one (1) case, which resulted in temporary hypocalcaemia in three (3) cases. Three (3) cases of Follicular Ca in which total thyroidectomy was performed, resulted in no cases of temporary hypocalcaemia. Conclusion: Re-operated surgeries, malignant thyroid pathology with neck dissection (central/ modified neck dissection) are associated with high chances of unintentional parathyroid gland removal leading to hypocalcaemia. The operating surgeon should consider these risk factors during recurrent malignant surgery with neck dissection.

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