Complications After Thyroidectomy in Children: Lymph Node Dissection Is a Risk Factor for Permanent Hypocalcemia

Area of Science:

• Pediatric Surgery
• Endocrinology
• Oncology

Background:

• Thyroidectomy is a key treatment for benign thyroid disorders and thyroid cancer.
• Postoperative complications and long-term health outcomes are critical due to low mortality rates.

Purpose of the Study:

• To determine the frequency and risk factors of short- and long-term complications following thyroidectomy in pediatric patients (0-18 years).

Main Methods:

• A retrospective single-center study included pediatric patients who underwent thyroidectomy between January 2013 and February 2020.
• Data on 48 patients (mean age 14.6 years) were analyzed, including total thyroidectomies (29) and hemithyroidectomies (19).

Main Results:

• Permanent hypocalcemia occurred in 20.7% of total thyroidectomy patients, primarily those with thyroid cancer and lymph node dissection (OR 43.73 for cancer, OR 76.14 for dissection).
• Transient hypocalcemia (34.5%) and recurrent laryngeal nerve injury (8.3% transient, 2.1% permanent) were also observed.

Conclusions:

• Permanent complications are rare after pediatric thyroidectomy without lymph node dissection.
• Thyroid cancer surgery with lymph node dissection significantly increases the risk of permanent hypocalcemia in children.
• Minimizing hypocalcemia is essential for improving the quality of life for pediatric thyroid cancer patients.