Highlights
- •Concurrent parathyroid surgery with thyroidectomy carries an 8-fold increased risk of complications compared with parathyroidectomy alone.
- •Hypoparathyroidism, recurrent laryngeal nerve injury, and hematoma are significantly more likely following concurrent surgery.
- •Hypocalcemia is the largest driver of endocrine-related ED visits and hospital admissions in the post-op period.
- •These findings may help guide surgeon-patient discussions on the risks of concurrent parathyroid and thyroid surgery.
Abstract
Background
Studies comparing endocrine-specific outcomes following parathyroidectomy (PTx) versus
concurrent parathyroidectomy and thyroidectomy (PTx + Tx) are few.
Methods
10,019 patients were selected from the Collaborative Endocrine Surgery Quality Improvement
Program (2014–2019). Baseline characteristics and short-term (≤30 days) outcomes for
PTx + Tx vs PTx patients were compared using bivariate and multivariable methods.
Results
PTx + Tx patients were more likely to experience clinical hypoparathyroidism (6.7%
vs 0.5%, p < 0.001), recurrent laryngeal nerve transection, (0.4% vs 0.1%, p = 0.002)
and hematoma requiring evacuation (1.0% vs 0.2%, p < 0.001). Readmissions and ED visits
for hypocalcemia were more frequent after PTx + Tx vs PTx. Concurrent surgery was
associated with an 8-fold increase in risk of short-term complications (Odds Ratio
(OR): 8.0, 95% Confidence Interval (CI): 5.7–11.1, p < 0.001).
Conclusions
Patients undergoing PTx + Tx have increased rates of postoperative complications,
ED visits, and readmissions compared to patients undergoing parathyroidectomy alone.
These findings could help guide surgeon-patient discussions on the risks of concurrent
surgery.
Keywords
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Article info
Publication history
Published online: March 25, 2022
Accepted:
March 23,
2022
Received in revised form:
February 26,
2022
Received:
December 19,
2021
Identification
Copyright
© 2022 Published by Elsevier Inc.