A new histopathological location of parathyroid gland with high possibility of unintended parathyroidectomy

Jae Gu Cho, Seok Youl Choi, Kyung Ho Oh, Seung Kuk Baek, Soon Young Kwon, Kwang Yoon Jung, Jeong Soo Woo

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Unintended parathyroidectomy occasionally happens despite meticulous capsular dissection and the histopathological location of removed parathyroid glands were traditionally classified as extracapsular, subcapsular, and intrathyroidal location. This study aimed to investigate the new histopathological location of parathyroid gland with high possibility of unintended parathyroidectomy that was difficult to be found with naked eye despite capsular dissection. Methods: This study investigated unintended parathyroidectomy that occurred in 743 patients who received thyroid surgery by reviewing pathology reports and slides. The histopathological location of unintentionally removed parathyroid glands was classified as intracapsule and extracapsule, and the intracapsular glands were further classified as completely buried in the thyroid parenchyme, partially buried, and subcapsular locations. Results: The incidence of unintended parathyroidectomy was 12.8%. Among the 103 unintentionally removed parathyroid glands, 74 (71.8%) were found intracapsular and 29 were extracapsular. Among the intracapsular glands, 57 (55.4%) parathyroid glands were found in difficult locations such as completely buried (40.8%) and partially buried (14.6%). Conclusions: The partially buried parathyroid gland can act as a risk factor for unintended parathyroidectomy comparable to intrathyroidal parathyroid gland despite the surgeon’s best effort with meticulous capsular dissection. However, continued advances in visualizing technique such as autofluorescence imaging may lower the chance of incidentally removed partially buried parathyroid glands in the future.

Original languageEnglish
Pages (from-to)1714-1721
Number of pages8
JournalGland Surgery
Volume12
Issue number12
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© (2023) Gland Surgery. All rights reserved.

Keywords

  • Parathyroidectomy
  • anatomy
  • histopathology
  • risk factor
  • thyroidectomy

ASJC Scopus subject areas

  • Surgery

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