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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
Thyroid surgery in 103 children in a single institution from 2000-2014
Osama Ibrahim Almosallam1, Ali Aseeri2, Ahmed Alhumaid1
1From the Department of Surgery, College of Medicine, Qassim University, Buraidah, Al Qassim, Saudi Arabia.
Insights
Thyroid cancer is the most common reason for pediatric thyroid surgery. Fine needle aspiration (FNA) is accurate, but complications like hypocalcemia and nerve injury occur, with a 15% recurrence rate in thyroid cancer.
Area of Science:
- Pediatric Surgery
- Endocrinology
- Oncology
Background:
- Data on pediatric thyroid surgery outcomes are limited.
- Thyroid surgery in children presents unique challenges and considerations.
- Understanding outcomes is crucial for improving pediatric surgical care.
Purpose of the Study:
- To analyze outcome data for pediatric patients undergoing thyroid surgery.
- To identify common indications, pathologies, and complications.
- To assess recurrence rates in pediatric thyroid cancer patients.
Main Methods:
- Retrospective medical record review of 103 pediatric patients (≤18 years) undergoing thyroid surgery from 2000-2014.
- Data collected included demographics, clinical details, indications, pathology, complications, and follow-up.
- Analysis of fine needle aspiration (FNA) diagnostic accuracy and outcomes of radioactive iodine treatment.
Main Results:
- Malignancy was the most common indication (64%), primarily papillary thyroid cancer.
- Fine needle aspiration (FNA) showed 94% correlation with final histopathology.
- Complications included hypocalcemia (22%) and recurrent laryngeal nerve injury (5.8%), with permanent issues in some cases.
- Recurrence rate for thyroid cancer was 15% after radioactive iodine treatment.
Conclusions:
- Malignancy is the primary indication for pediatric thyroid surgery.
- Fine needle aspiration (FNA) is a highly accurate diagnostic tool.
- Hypocalcemia and recurrent laryngeal nerve injury are significant potential complications.
- A 15% recurrence rate highlights the need for vigilant follow-up in pediatric thyroid cancer.
Background:
Data on thyroid surgery in children are scarce.
Objective:
Analyze outcome data on thyroid surgery in a pediatric population.
Design:
Medical record review.
Setting:
Tertiary health care institution.
Patients And Methods:
We collected demographic and clinical data on patients 18 years or younger who had thyroid surgery in the period 2000 to 2014. Descriptive data are presented.
Main Outcome Measures:
Indications for thyroidectomy, thyroid pathology, complications, length of stay, and radioactive iodine treatment and recurrences.
Sample Size:
103.
Results:
Of 103 patients who underwent 112 thyroidectomy procedures, 80 (78%) were females and the mean age at operation was 13.2 years. and 17 (16%) were associated with multiple endocrine neoplasia type 2. There was no history of radiation exposure. Eighty-one patients (78%) had fine needle aspiration (FNA) which correlated with the final histopathology in 94% of cases. Sixty-six patients (64%) had malignant cancer (61 papillary), 44 (74.6%) of 59 patients who had neck dissection had lymph node metastasis and 7 (11%) had distant metastases to the lung. Procedures included total thyroidectomy (50%), hemithyroidectomy (17%), completion (31%), and subtotal thyroidectomy (2%). Twenty-three patients (22%) developed hypocalcemia (3 permanent) and 6 (5.8%) had unilateral recurrent laryngeal nerve injury (3 permanent). Patients were followed up for a mean duration of 71.7 months (median 60 months). Of 66 patients with thyroid cancer, 43 (65%) received radioactive iodine, and 10 (15%) had recurrence.
Conclusion:
Malignancy is the commonest indication for thyroid surgery in children and FNA is highly diagnostic. Hypocalcemia and recurrent laryngeal nerve injury are significant complications. The recurrence rate in thyroid cancer is 15%.
Limitations:
Retrospective.
Conflict Of Interest:
None.
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