Does concomitant thyroidectomy increase risks of parathyroidectomy?

BACKGROUND

Concomitant thyroid pathology in patients with primary hyperparathyroidism is common. This study compares complications of patients who underwent parathyroidectomy to those who underwent parathyroidectomy with a concomitant thyroidectomy.

METHODS

A retrospective review of prospectively collected data on 709 patients who underwent parathyroidectomy was performed. Patients who had prior thyroid or parathyroid procedures were excluded. Chi-square, Fisher's exact, Student's t-test, and Wilcoxon rank-sum tests were used to compare cohorts.

RESULTS

Of the 641 patients included, 90% underwent parathyroidectomy alone and 10% underwent parathyroidectomy with a concomitant thyroidectomy. Overall, 49% had preoperative thyroid disease and 22% of patients with thyroid disease had a thyroid procedure. When compared with parathyroidectomy alone, parathyroidectomy with a concomitant thyroidectomy was associated with longer operative times (91 min versus 57 min, P < 0.001), increased rate of overnight stay (69% versus 17%, P < 0.001), and increased rate of transient hypocalcemia (15% versus 3%, P < 0.001).

CONCLUSIONS

Parathyroidectomy with a concomitant thyroidectomy is associated with longer operative times, increased rate of overnight stay, and increased transient hypocalcemia.