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Updated: Aug 24, 2025
Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Short-term pediatric thyroidectomy outcome: Analysis of the Pediatric Health Information System (PHIS) database
Wen Jiang1, Matt Hall2, Ron Newfield3
1Department of Otolaryngology, University of California San Diego, San Diego, CA, USA; Rady Children's Hospital in San Diego, San Diego, CA, USA.
Insights
Pediatric thyroidectomy complications, mainly hypocalcemia, occurred in 27.7% of cases. Factors like young age and complex conditions increased risk, while partial thyroidectomy reduced it. Surgical volume did not impact outcomes.
Area of Science:
- Pediatric Surgery
- Endocrine Surgery
- Health Outcomes Research
Background:
- Thyroidectomy is a common endocrine surgery in children.
- Understanding short-term outcomes and complications is crucial for pediatric surgical care.
Purpose of the Study:
- To assess short-term outcomes of pediatric thyroidectomies.
- To identify factors associated with postoperative complications in children.
Main Methods:
- Retrospective cohort study using the Pediatric Health Information System (PHIS) database.
- Analysis of 6405 patients (≤18 years) undergoing thyroidectomy between 2009-2019 across 47 US children's hospitals.
Main Results:
- Overall complication rate was 27.7%, with hypocalcemia being most frequent (15.6%).
- Younger age (<1 year), specific races, and complex chronic conditions were linked to higher complication rates.
- Partial thyroidectomy was associated with fewer complications than total thyroidectomy; neck dissections and parathyroid re-implantations increased risk.
Conclusions:
- Endocrine complications dominate surgical morbidity post-pediatric thyroidectomy.
- Surgical volume did not correlate with complication rates.
- Achievable Benchmarks of Care (ABC) can guide quality improvement efforts.
Objective:
Thyroidectomy is the most commonly performed pediatric endocrine surgery. Our objective is to measure the short-term outcome of pediatric thyroidectomies, and report on factors associated with postoperative complications.
Methods:
This is a retrospective cohort study, performed using the Pediatric Health Information System (PHIS) database on patients ≤18 years of age, from 47 children's hospitals across the United States, who underwent partial or total thyroidectomy from January 1, 2009 to December 31, 2019.
Results:
A total of 6405 patients were included, mostly female (76.8%), and 46.9% were 15-18 years-old. Age <1 year, Hispanic and Black race, comorbidity with complex chronic conditions were associated with more complications. The overall short-term complication rate was 27.7%, with hypocalcemia accounting for the majority (15.6%). Complication rates were lower in benign or non-specific thyroid nodules as compared with malignancy and Graves' disease. Complication rates were significantly lower for partial thyroidectomy versus total thyroidectomy and both neck dissections and parathyroid re-implantations were associated with increased risk of complications. The mean length of stay was 1.4 days. Complications were associated with prolonged hospital stay (2.4 vs. 1.2 days) and increased cost ($19441 vs. $11232) (p < 0.001), but not associated with hospital volume (p = 0.36).
Conclusion:
Endocrine-related complications accounts for the majority of surgical morbidity following pediatric thyroidectomies performed at pediatric hospitals, and complications does not appear to be correlate with surgical volume. The calculated Achievable Benchmarks of Care (ABC) pooled complication rates from the top performing hospitals may serve as a goal for improvement.
