The impact of raised body mass index on parathyroid surgery: a single centre experience

Background The prevalence of obesity continues to rise and presents increasing challenges in surgical care. Elevated body mass index (BMI) may affect perioperative management and outcomes. This study evaluates the impact of obesity on operative metrics in parathyroid surgery. Methods A retrospective review of 225 consecutive parathyroid surgeries performed by a single surgeon between September 2019 and September 2023 was conducted. Patient demographics, BMI, surgical time, preoperative imaging, and biochemical parameters were analyzed. Patients were categorized as normal weight, overweight, or obese according to WHO BMI classifications. Results Among 225 patients, 89 (39.6%) were of normal weight, 81 (36.0%) were overweight, and 55 (24.4%) were obese. Obese patients had significantly longer surgical times than normal-weight patients (p < 0.001). Four-gland exploration was also associated with longer surgical times as was bilateral neck exploration (P<0.05). Obese patients exhibited higher preoperative parathyroid hormone (PTH) levels (p < 0.01). Conclusion Obesity was independently associated with prolonged surgical times and elevated preoperative PTH levels in patients undergoing parathyroidectomy, though complication rates were comparable across BMI categories.