This study identifies risk factors and 30-day adverse outcomes of pediatric patients undergoing thyroidectomy.
Methods:
Retrospective analysis utilizing the American College of Surgeons National Surgical Quality Improvement–Pediatric Database (2015-2016). Study population includes pediatric patients (≤18 years) who underwent hemithyroidectomy (HT), total thyroidectomy (TT), and total thyroidectomy with central neck dissection (TT+ND).
Results:
A total of 720 cases were identified; mean age at time of surgery was 14.1 years, with a female-to-male ratio of 3.4:1. Following hospital discharge, there were 10 related readmissions, with 1 patient requiring reoperation for neck hematoma evacuation. Regression analysis revealed anesthesia time had a significant impact on total length of stay (P = .0020).
Conclusion:
Contemporary pediatric thyroidectomy has a low incidence of 30-day general surgical postoperative complications. Future research efforts are necessary once thyroidectomy specific variables are incorporated into ACS-NSQIP-P, which will provide further insights into managing this unique patient population.
DinauerCABreuerCRivkeesSA.Differentiated thyroid cancer in children: diagnosis and management. Curr Opin Oncol. 2008;20:59-65.
2.
ShapiroNLBhattacharyyaN.Population-based outcomes for pediatric thyroid carcinoma. Laryngoscope. 2005;115:337-340.
3.
RapkinLPashankarFD.Management of thyroid carcinoma in children and young adults. J Pediatr Hematol Oncol. 2012;34:S39-S46.
4.
ThompsonGBHayID.Current strategies for surgical management and adjuvant treatment of childhood papillary thyroid carcinoma. World J Surg. 2004;28:1187-1198.
AstlJDvorákováMVlcekPVeselýDMatuchaPBetkaJ.Thyroid surgery in children and adolescents. Int J Pediatr Otorhinolaryngol. 2004;68:1273-1278.
7.
Steliarova-FoucherEStillerCAPukkalaELacourBPleskoIParkinDM.Thyroid cancer incidence and survival among European children and adolescents (1978–1997): report from the Automated Childhood Cancer Information System project. Eur J Cancer. 2006;42:2150-2169.
8.
FrancisGLWaguespackSGBauerAJ, et al. Management guidelines for children with thyroid nodules and differentiated thyroid cancer. Thyroid. 2015;25:716-759.
DillonPHammermeisterKMorratoE, et al. Developing a NSQIP module to measure outcomes in children’s surgical care: opportunity and challenge. Semin Pediatr Surg. 2008;17:131-140.
11.
RoxburyCRYangJSalazarJShahRKBossEF.Safety and postoperative adverse events in pediatric otologic surgery: analysis of American College of Surgeons NSQIP-P 30-day outcomes. Otolaryngol Head Neck Surg. 2015;152:790-795.
12.
MahidaJBAstiLPepperVKDeansKJMinneciPCDiefenbachKA.Comparison of 30-day outcomes between thoracopic and open lobectomy for congenital pulmonary lesions. J Laparoendosc Adv Surg. 2015;25:435-440.
13.
CramerJDPatelUASamantSYangASmithSS.Liver disease in patients undergoing head and neck surgery: incidence and risk for postoperative complications. Laryngoscope. 2017;127:102-109.
14.
VlastarakosPVCandilorosDPapacharalampousG, et al. Diagnostic challenges and safety considerations in cochlear implantation under the age of 12 months. Int J Pediatr Otorhinolaryngol. 2010;74:127-132.
15.
KimYPatelVAIsildakHCarrMM.An analysis of safety and adverse events following cochlear implantation in children under 12 months of age. Otol Neurotol. 2017;38:1426-1432.
16.
PatelVARamadanJCarrMM.Congenital Choanal atresia repair: an analysis of adverse postoperative events. Otolaryngol Head and Neck Surg. 2018;159:920-926.
17.
HarounianJPatelVACarrMM.An analysis of perioperative outcomes following cervical abscess drainage in children under 2 years. Int J Pediatr Otorhinolaryngol. 2019;116:125-129.
LedbetterDJ.Thyroid surgery in children. Semin Pediatr Surg. 2014;23:60-65.
20.
WémeauJLSadoulJLd’herbomezM, et al. [Recommendations of the French Society of Endocrinology for the management of thyroid nodules]. Presse Med. 2011;40:793-826.
21.
SosaJATuggleCTWangTS, et al. Clinical and economic outcomes of thyroid and parathyroid surgery in children. J Clin Endocrinol Metab. 2008;93:3058-3065.
22.
ElfenbeinDMKatzMSchneiderDFChenHSippelRS.Thyroidectomy for Graves’ disease in children: indications and complications. J Pediatr Surg. 2016;51:1680-1683.
23.
TayCLTanGMNgSB.Critical incidents in pediatric anesthesia: an audit of 10,000 anesthetics in Singapore. Paediatr Anaesth. 2001;11:711-718.
24.
RavalMVBrowneMChinACZimmermanDAngelosPReynoldsM.Total thyroidectomy for benign disease in the pediatric patient–feasible and safe. J Pediatr Surg. 2009;44:1529-1533.
25.
KundelAThompsonGBRichardsML, et al. Pediatric endocrine surgery: a 20-year experience at the Mayo Clinic. J Clin Endocrinol Metab. 2014;99:399-406.
26.
ScholzSSmithJRChaignaudBShambergerRCHuangSA.Thyroid surgery at Children’s Hospital Boston: a 35-year single-institution experience. J Pediatr Surg. 2011;46:437-442.
27.
HanbaCSviderPFSiegelB, et al. Pediatric thyroidectomy. Otolaryngol Head Neck Surg. 2017;156:360-367.
28.
WoodJHPartrickDABarhamHP, et al. Pediatric thyroidectomy: a collaborative surgical approach. J Pediatr Surg. 2011;46:823-828.
29.
YoungwirthLMAdamMAThomasSMRomanSASosaJAScheriRP.Pediatric thyroid cancer patients referred to high-volume facilities have improved short-term outcomes. Surgery. 2018;163:361-366.
