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Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Pediatric thyroidectomy: a collaborative surgical approach
James H Wood1, David A Partrick, Henry P Barham
1Department of Surgery, University of Colorado Denver School of Medicine, Aurora, CO, USA.
Insights
A collaborative pediatric thyroid surgery approach involving pediatric and endocrine surgeons improves outcomes. This team-based strategy optimizes care for children with thyroid disease, minimizing complications.
Area of Science:
- Pediatric Surgery
- Endocrine Surgery
- Surgical Outcomes
Background:
- A collaborative pediatric thyroid surgery model was developed, involving pediatric surgeons and endocrine surgeons operating at a children's hospital.
- This approach aims to overcome specialist limitations and enhance care for pediatric patients with surgical thyroid conditions.
Purpose of the Study:
- To evaluate the effectiveness of a collaborative pediatric thyroid surgery approach.
- To assess surgical outcomes and complications in children undergoing thyroidectomy.
Main Methods:
- Retrospective analysis of partial and total thyroidectomies performed between 1995 and 2009.
- Data collected from a tertiary children's hospital, with statistical analysis using IBM SPSS software.
Main Results:
- Thirty-five children underwent thyroid surgery (lobectomy or total thyroidectomy).
- Common indications included thyroid nodules (71%) and genetic predisposition to malignancy (17%).
- Low complication rates (11%) were observed, with transient hypocalcemia in 4 cases post-total thyroidectomy; no nerve injuries occurred. Shorter hospital stays were noted for lobectomy compared to total thyroidectomy.
Conclusions:
- Collaborative pediatric thyroidectomy and lobectomy by high-volume endocrine and pediatric surgeons yield optimal outcomes.
- A dedicated pediatric medical center enhances surgical results for pediatric thyroid disease.
Introduction:
We have developed a collaborative approach to pediatric thyroid surgery, with operations performed at a children's hospital by a pediatric surgeon and an endocrine surgeon. We hypothesize that this strategy minimizes specialist-specific limitations and optimizes care of children with surgical thyroid disease.
Methods:
Data from all partial and total thyroidectomies performed by the pediatric-endocrine surgery team at a tertiary children's hospital between 1995 and 2009 were collected and analyzed retrospectively. Statistical analyses were performed with IBM SPSS software (SPSS, Chicago, IL).
Results:
Thirty-five children met the inclusion criteria (69% female; median age, 13 years; median follow-up, 1119 days). The indications for operation were thyroid nodule (71%), genetic abnormality with predisposition to thyroid malignancy (17%), multinodular goiter (5.7%), Grave disease (2.9%), and Hashimoto thyroiditis (2.9%). Sixteen children (46%) underwent thyroid lobectomy, and 19 children (54%) underwent total thyroidectomy. Median length of stay was 1 day (1 day after lobectomy vs 2 days after total thyroidectomy, P < .0001). There were 4 cases of transient hypocalcemia after total thyroidectomy, but there were no nerve injuries or other in-hospital complications in either group (overall complication rate, 11%).
Conclusions:
For pediatric thyroidectomy and thyroid lobectomy, collaboration of high-volume endocrine and pediatric surgeons as well as pediatric endocrinologists at a dedicated pediatric medical center provides optimal surgical outcomes.
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