Indian Journal of Endocrine Surgery and Research

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VOLUME 18 , ISSUE 2 ( July-December, 2023 ) > List of Articles


A Pilot Study on Parathyroid Identification, Confirmation, and Autoimplantation from Thyroidectomy Specimen

Raja Suman Datta Aduri, Komal Gupta, Sunil Chumber, Yashwant Rathore, Kamal Kataria

Keywords : Endocrine surgery, Parathyroidectomy, Thyroidectomy

Citation Information : Aduri RS, Gupta K, Chumber S, Rathore Y, Kataria K. A Pilot Study on Parathyroid Identification, Confirmation, and Autoimplantation from Thyroidectomy Specimen. 2023; 18 (2):58-63.

DOI: 10.5005/jp-journals-10088-11223

License: CC BY-NC 4.0

Published Online: 12-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Introduction: Parathyroid identification and preservation are important components of safe thyroid surgery and can significantly reduce the morbidity associated with thyroidectomy. Our study focuses on identifying parathyroid glands by their gross appearance during intraoperative bench dissection of the thyroidectomy specimen with confirmation by histopathological examination (frozen section). Materials and methods: This is a prospective, nonrandomized cohort study conducted from August 2017 to March 2019. Patients with various thyroid disorders undergoing thyroid surgery were included in the study. The excised thyroidectomy specimen was inspected to identify parathyroid glands based on five morphological criteria including location, color, size, presence of a vascular pedicle, and saline floatation test. Confirmation with the frozen section as a gold standard test was performed. Autoimplantation of confirmed parathyroid glands was performed. Results: A total of 41 patients were included. The prevalence of incidental parathyroidectomy (IP) was found to be 9.76% (4 out of 41) [95% confidence interval (CI): 2.72–23.13%] in our study. The sensitivity of the bench dissection of the thyroidectomy specimen was 25% (95% CI: 0.63–80.59%) and the specificity was 94.59% (95% CI: 81.81–99.34%). The positive likelihood ratio was 4.62 (95% CI: 0.53–40.41) and the negative likelihood ratio was 0.79 (95% CI: 0.45–1.40). The positive predictive value was 33.33% (95% CI: 5.41–81.37%), the negative predictive value was 92.11% (95% CI: 86.83–95.38%), and the accuracy was 87.80% (73.80–95.92%). Conclusion: Gross criteria used for identification of parathyroid glands are fairly accurate (87.80%) with high specificity (94.59%) and negative predictive value (92.11%).

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