Outcomes of concurrent parathyroidectomy and thyroidectomy among CESQIP surgeons

Am J Surg. 2022 Nov;224(5):1190-1196. doi: 10.1016/j.amjsurg.2022.03.041. Epub 2022 Mar 26.

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: CESQIP; Hypocalcemia; Parathyroidectomy; Post-operative complications; Thyroidectomy.

MeSH terms

  • Humans
  • Hypocalcemia* / etiology
  • Hypoparathyroidism* / epidemiology
  • Hypoparathyroidism* / etiology
  • Parathyroidectomy / methods
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Surgeons*
  • Thyroidectomy / adverse effects