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Outcomes of concurrent parathyroidectomy and thyroidectomy among CESQIP surgeons

      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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