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Updated: Aug 5, 2025
Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Hospital volume as a predictor of outcomes following pediatric thyroidectomy
Victor J Yu1, Daniel Cyrus Sasson2, Daniel Scholfield3
1Division of Plastic and Reconstructive Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA.
Insights
In pediatric thyroid cancer surgery, younger age and concurrent neck dissection increase complication risks. Hospital volume did not significantly impact outcomes in this study.
Area of Science:
- Pediatric Surgery
- Endocrinology
- Oncology
Background:
- Pediatric thyroidectomy (PT) is a rare surgery with potential for significant complications.
- Understanding factors influencing short-term complications is crucial for improving patient outcomes.
Purpose of the Study:
- To identify factors associated with short-term (30-day) post-thyroidectomy complications in children with thyroid cancer.
- To analyze the impact of hospital volume on complication rates.
Main Methods:
- Utilized the 2012 and 2016 Kids' Inpatient Databases (KID).
- Included all pediatric patients undergoing thyroidectomy for thyroid cancer.
- Categorized complications (endocrine, nervous, pulmonary, other) and analyzed risk factors using statistical tests, stratifying by hospital volume (high-volume centers [HVC] vs. non-high-volume centers [NHVC]).
Main Results:
- A total of 663 patients were analyzed, with a mean age of 15.93 years.
- The overall complication rate was 32.1%, with endocrine complications being most frequent (32.7%).
- Independent predictors for any or endocrine complications included younger age (OR=0.927) and concurrent neck dissection (OR=1.679); hospital volume did not significantly affect complication odds.
Conclusions:
- Younger age and concurrent neck dissection are significant risk factors for complications in pediatric thyroid cancer surgery.
- Hospital volume did not demonstrate a significant association with complication rates.
- Further research is needed to explore the influence of individual surgeon volume versus hospital volume on complication risks.
Background:
Pediatric thyroidectomy (PT) is an uncommon procedure with a risk of significant morbidity. This study utilizes a national database to identify factors associated with short-term (30-day) post-thyroidectomy complications in children with thyroid cancer.
Methods:
The 2016 and 2012 Kids' Inpatient Databases (KID) were used in this study. All children with thyroid cancer undergoing thyroidectomy were included. Complications were categorized into endocrine, nervous, pulmonary, and other. Hospital volume was stratified into high-volume (performing the top 10% of total cases, HVC) or non-high-volume centers (NHVC). Risk factors were analyzed using univariable and multivariable statistical tests.
Results:
Six hundred and sixty-three patients with an average age of 15.93 years met inclusion criteria. Most patients were seen in an NHVC (90.0%) and 37.3% of thyroidectomies were performed with neck dissections. The incidence of any complication was 32.1%. Endocrine complications were the most frequent (32.7%). Independent predictors of any or only endocrine complications were age (odds ratio [OR] = 0.927, p = 0.002, any; OR = 0.926, p = 0.003, endocrine) or concurrent neck dissection (OR = 1.679, p = 0.004, any; OR = 1.683, p = 0.005, endocrine). There was no statistically significant change in odds with hospital volume.
Conclusions:
Further investigation into the effect of single surgeon versus hospital volume on the risk of complications in pediatric thyroid cancer surgery is warranted.
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