Contact endoscopy for identifying the parathyroid glands during thyroidectomy

• Published in: Acta otorhino-laryngologica italica Vol. 30; no. 1; pp. 20 - 26
• Main Authors: GUIMARAES, A. V, BRANDAO, L. G, DEDIVITIS, R. A
• Format: Journal Article
• Language: English
• Published: Pisa Pacini 01.02.2010; Pacini Editore SpA
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Endoscopy; Female; Humans; Intraoperative Care - methods; Male; Medical sciences; Middle Aged; Otorhinolaryngology. Stomatology; Parathyroid Glands - anatomy & histology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of endocrine glands; Thyroid Surgery; Thyroidectomy; Young Adult; Treatment; Surgery; Contact Endoscopy; Parathyroid glands; ENT; Thyroid gland; Endoscopy; Thyroidectomy
• ISSN: 0392-100X; 1827-675X

Aim of this study was to analyse contact endoscopy as an auxiliary method for identifying parathyroid glands during thyroid surgery and to identify other variables that may interfere with this correlation. Overall, 125 patients underwent thyroid surgery between January 2004 and February 2006. The variables analysed were: the total duration of surgery; time taken to locate and identify parathyroid glands; improvement in identifying these; numbers of parathyroid glands located by the surgeon and confirmed by contact endoscopy; histopathological diagnosis; presence of thyroiditis; thyroid weight; number of parathyroid glands left in thyroid specimens; and number of parathyroid gland autotransplantations. A total of 331 parathyroid glands were observed by the surgeon. However, 282 glands were identified by contact endoscopy. Nine parathyroid glands (7.2%) were observed together with thyroid specimens (Kappa = 0.534). The longer the total duration of surgery (p = 0.03) and time taken to locate and identify (p = 0.00) the parathyroid glands by contact endoscopy, the lower the observed agreement. The second year of performing contact endoscopy led to better agreement between the results (p = 0.02). In conclusion, contact endoscopy is an efficient auxiliary method for identifying parathyroid glands during thyroid surgery. During the period studied, association between total duration of surgery and time taken to locate and identify parathyroid glands was statistically significant.