Iatrogenic Parathyroidectomy and Affecting Factors During Thyroid Surgery

Aim: This study aimed to investigate cases of iatrogenic parathyroidectomy following thyroid surgery and to analyze the causes.Material and Methods: A total of 287 patients diagnosed with thyroid-related disorders and surgically treated at various clinics of Private Esencan Hospital between 2019 and 2023 were included in the study.Preoperative ultrasound imaging results and data on patients with multinodular goiter presenting a dominant nodule larger than 4 cm in diameter were recorded, specifically noting the presence of thyroiditis.Thyroid tissues obtained during surgery were examined histopathologically in the pathology laboratory, and the presence of thyroid malignancy and parathyroid tissue was confirmed. Results:The mean age of the patients was 55.617.3years, ranging from 18 to 83 years, and 154 (55.4%) were male.Iatrogenic parathyroidectomy was identified in 26 (9.4%) of the patients.The rate of iatrogenic parathyroidectomy was significantly higher in patients with thyroid malignancy compared to those without (13.9% vs. 5.8%; p=0.02).Patients with thyroiditis also had a higher rate of iatrogenic parathyroidectomy than those without (18.2% vs. 7.2%; p=0.012).Additionally, patients with a dominant nodule diameter showed a significantly increased rate of iatrogenic parathyroidectomy compared to those without (27.0%vs. 6.6%;p<0.001).In the logistic regression analysis, the presence of thyroid malignancy (p=0.024),thyroiditis (p=0.015), and dominant nodule diameter (p<0.001) were identified as independent risk factors for developing iatrogenic parathyroidectomy. Conclusion:Our study shows that the risk of iatrogenic parathyroidectomy is significantly higher, especially in patients with thyroiditis, thyroid malignancy, or large nodules.These patients should be handled more carefully during surgery and should be considered for surgical treatment.