ABSTRACT
This chapter discusses the specific problems that may occur during operations on the important endocrine glands and describes some methods that can reduce the risk of postoperative hematoma, recurrent and superior laryngeal nerve palsy, hypocalcemia, seroma, wound infection, and parathyroidectomy operative failure. Postoperative hypocalcemia can be a serious complication after total thyroidectomy or extensive parathyroidectomy. During parathyroidectomy, the surgeon should never excise any gland of normal size in an attempt to return the patient to normocalcemia. During unilateral thyroidectomy, normal parathyroid glands should not be resected on the basis of an assumption that contralateral thyroid lobectomy will not be necessary in the future. Parathyroidectomy is performed to eliminate the excess secretion of parathyroid hormone. Complications associated with surgical procedures involving the thyroid and parathyroid glands are fortunately uncommon when these procedures are performed by experienced surgeons. Conversely, even in experienced hands, these complications occur, leading to substantial morbidity to these patients.
