Parathyroidectomy—Conventional

(Parathyroidectomy—Open; Parathyroidectomy—Standard; Parathyroid Gland Removal—Conventional; Parathyroid Gland Removal—Open; Parathyroid Gland Removal—Standard)
  • Definition

    A parathyroidectomy is a surgery to remove parathyroid glands. There are four parathyroid glands located in the neck. The glands make a hormone that balance the level of calcium in the blood.
    Parathyroid Glands and Thyroid Glands (Back View)
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  • Reasons for Procedure

    The surgery is done to remove one or more abnormal parathyroid glands. The glands may be abnormal due to cancer or for other reasons.
  • Possible Complications

    Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
    • Bleeding
    • Hoarseness
    • Low calcium levels in the blood—more common if all 4 glands are removed
    • Wound infection
    • Reaction to the anesthesia
    • Skin tethering—tissues and skin may become attached to the voice box or windpipe
    • Scarring
    • Blocked airway
    • Damage to nerves, which can cause problems like paralyzed vocal cords
    Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
  • What to Expect

    Prior to Procedure
    Your doctor will:
    • Do a physical exam and ask you about your medical history
    • Order imaging test such as ultrasound or parathyroid scan
    • Have blood tests done
    You should:
    • Arrange to have someone drive you home from the hospital after surgery.
    • Avoid eating or drinking 6-8 hours before surgery.
    • Talk to your doctor about your medications, herbs, and dietary supplements. You may be asked to stop taking some medications up to one week before the procedure.
    Anesthesia
    General anesthesia is used most often. It will block any pain and you will stay asleep through the surgery. In some cases, local anesthesia may be used instead. The area will be numb but you will be awake.
    Description of the Procedure
    An incision will be made in the neck. Muscle and other tissue will be moved to locate all the glands. The abnormal gland or glands will then be cut out and removed. A drain may then be placed in the area. This will allow fluids to drain out of the area while you heal. If all four glands were removed, a part of one gland may be placed in a different area of the neck or in the forearm. The incision will be closed with stitches.
    How Long Will It Take?
    20 minutes to several hours, depending on how many glands need to be removed
    How Much Will It Hurt?
    Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
    Average Hospital Stay
    You may need to stay in the hospital for 1-2 days. Your doctor may choose to keep you longer if you have any problems.
    Post-procedure Care
    At the Hospital
    After your surgery, the the hospital staff will:
    • Observe you in the recovery room.
    • Check on your ability to swallow and speak.
    • Test your calcium levels.
    • Show you how to change your dressings and care for your wound.
    • Remove the drain if one was placed during surgery.
    Preventing Infection
    During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
    • Washing their hands
    • Wearing gloves or masks
    • Keeping your incisions covered
    There are also steps you can take to reduce your chance of infection, such as:
    • Washing your hands often and reminding your healthcare providers to do the same
    • Reminding your healthcare providers to wear gloves or masks
    • Not allowing others to touch your incision
    At Home
    Be sure to follow your doctor’s instructions. To help your recovery at home:
    • You may be given calcium supplements.
    • You will be given instruction about caring for your wound. Check your wound daily for signs of infection.
    • You may want to eat semi-solid foods like ice cream or oatmeal for the first few days. These types of foods will be easier to swallow.
  • Call Your Doctor

    Call your doctor if any of the following occur:
    • Tingling or numbness in the fingertips, toes, hands, or around the mouth
    • Twitching or cramping of muscles
    • Redness, warmth, drainage, or swelling around the area where surgery was done
    • Difficulty swallowing, talking, or breathing
    • Signs of infection, including fever and chills
    If you think you have an emergency, call for medical help right away.
  • RESOURCES

    EndocineDiseases.org - The American Association of Endocrine Surgeons http://endocrinediseases.org

    The American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org

    CANADIAN RESOURCES

    Canadian Cancer Society http://www.cancer.ca

    Canadian Society of Otolaryngology http://www.entcanada.org

    References

    Farndon JR. Surgical treatment: Evidence-based and problem-oriented. Postoperative complications of parathyroidectomy. Available at: http://www.ncbi.nlm.nih.gov/books/NBK6967. Accessed June 18, 2013.

    Parathyroid surgery. The American Association of Endocrine Surgeons website. Available at: http://endocrinediseases.org/parathyroid/surgery%5Foverview.shtml. Accessed June 18, 2013.

    Parathyroidectomy. Cedars-Sinai website. Available at: http://cedars-sinai.edu/Patients/Programs-and-Services/Head-and-Neck-Cancer-Center/Treatment/Parathyroidectomy.aspx. Accessed June 18, 2013.

    6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

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