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Higher Complication Rates for Total versus Partial Thyroidectomy in the Pediatric Population
Brent A Willobee1, Carlos T Huerta1, Hallie J Quiroz1
1DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida; University of Miami Miller School of Medicine, Miami, Florida.
The Journal of Surgical Research
|November 26, 2022
Summary
Total thyroidectomy in children is linked to higher complication rates, including hypocalcemia and nerve injury, compared to partial thyroidectomy. Surgeons should weigh these risks when deciding on the best surgical approach for pediatric patients.
Area of Science:
- Pediatric Surgery
- Endocrine Surgery
- Otolaryngology
Background:
- Thyroidectomy is a common procedure in pediatric patients.
- Understanding complication rates for total versus partial thyroidectomy is crucial for optimal patient care.
- Previous studies have not comprehensively compared these outcomes in a large pediatric cohort.
Purpose of the Study:
- To compare the complication rates and outcomes of total thyroidectomy versus partial thyroidectomy in the pediatric population.
- To identify specific risks associated with each surgical approach.
- To provide evidence-based guidance for surgeons performing pediatric thyroidectomies.
Main Methods:
- Analysis of the Kids' Inpatient Database (KID) from 1997-2012.
- Inclusion of all pediatric cases undergoing total (n=3253) or partial (n=2380) thyroidectomy.
- Utilized propensity score matching to compare outcomes based on surgical complications.
Main Results:
- The study cohort had a median age of 16 years, with 79% females.
- Malignancy (46%) and goiter (42%) were primary indications for surgery.
- Total thyroidectomy was associated with significantly higher rates of postoperative complications, including hypocalcemia (9%) and nerve injury (3%), and a longer median hospital stay compared to partial thyroidectomy.
Conclusions:
- This study represents the largest analysis to date comparing total versus partial thyroidectomy outcomes in children.
- Increased rates of hypocalcemia and nerve injury complications are associated with total thyroidectomy.
- Surgeons must consider these elevated risks when selecting between total and partial thyroidectomy for pediatric patients.
