Initial outcomes at a nascent tertiary pediatric thyroid surgical center

Area of Science:

• Pediatric Surgery
• Otolaryngology
• Endocrinology

Background:

• High-volume centers are often associated with better outcomes in pediatric thyroid surgery.
• Nascent surgical practices face challenges in achieving comparable results.

Purpose of the Study:

• To evaluate the initial outcomes of a new pediatric thyroid surgery practice.
• To determine if a low-volume center can safely evolve into a higher-volume center.
• To assess the feasibility of achieving favorable outcomes at centers with lower patient volumes.

Main Methods:

• Retrospective chart review of pediatric thyroid surgeries from 2014-2020.
• Analysis of postoperative complications, including recurrent laryngeal nerve injury and hypoparathyroidism.
• Involvement of a multidisciplinary team including pediatric otolaryngologists and endocrinologists.

Main Results:

• 31 pediatric patients underwent thyroid surgery, with 9 having neck dissections.
• Low complication rates observed: 2.0% permanent recurrent laryngeal nerve paralysis and 2.7% permanent hypoparathyroidism.
• Common diagnoses included papillary thyroid carcinoma (46.9%) and follicular adenoma (18.8%).

Conclusions:

• Favorable outcomes are achievable in nascent pediatric thyroid surgery centers with initially low volumes.
• New centers can safely transition to intermediate or high-volume status.
• This approach can enhance patient access to specialized pediatric thyroid surgical care.