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Updated: May 6, 2026
Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Outcomes in Pediatric Thyroid Surgery Across Multiple Institutions
Raj Roy1, Abhirami Babu2, Zhixing Song1
1Department of Endocrine Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Insights
Pediatric thyroid surgery is generally safe, but carries a significant risk of temporary low calcium (hypocalcemia) or parathyroid issues. Other complications are infrequent, affecting less than 3% of young patients.
Area of Science:
- Pediatric Surgery
- Endocrinology
- Otolaryngology
Background:
- Thyroid disease management in children is increasingly common.
- Surgical intervention is a key treatment modality for pediatric thyroid conditions.
- Evaluating surgical outcomes in young patients is essential.
Purpose of the Study:
- To meta-analyze the outcomes of thyroid surgery in pediatric, adolescent, and young adult populations.
- To assess complication rates and hospital stay following pediatric thyroidectomy.
- To provide a comprehensive overview of surgical results across multiple institutions.
Main Methods:
- A systematic literature search was conducted across major scientific databases (PubMed, Scopus, etc.).
- Data on hospital stay, transient, and permanent complications were extracted from 32 eligible studies.
- Meta-analysis of complication rates was performed using the metaprop library in R studio.
Main Results:
- The study included 2747 patients with a mean age of 12.9 years.
- Mean hospital stay was 2.6 days.
- Transient hypocalcemia/hypoparathyroidism occurred in 24% of patients, while transient laryngeal nerve injury was 2%. Permanent complications, including hypocalcemia and laryngeal nerve injury, were below 3%.
Conclusions:
- Thyroid surgery in pediatric patients is safe but associated with a high incidence of transient hypocalcemia or hypoparathyroidism.
- Permanent complications are infrequent, occurring in less than 3% of cases.
- The findings highlight the need for careful monitoring of calcium levels post-surgery in pediatric patients.
Introduction:
Surgical management plays a crucial role in managing thyroid disease in the pediatric population as evidenced by the increasing volume of such cases over the years. This study aims to evaluate the outcomes of thyroid surgery in children, adolescents, and young adults by meta-analyzing outcomes across several institutions.
Methods:
A comprehensive literature search for single institutional studies was performed across PubMed, Science Direct, Embase, Scopus, and Google Scholar. Key variables like mean hospital stay and both transient and permanent complications were recorded. Transient hypocalcemia or hypoparathyroidism was defined as a drop in serum calcium below laboratory reference range postthyroidectomy that resolved within 6 mo. Transient laryngeal nerve injury was characterized by hoarseness or dysphonia arising from neuropraxia or trauma to the nerve that resolved within 6 mos postsurgery. Complications persisting beyond 6 mo were classified as permanent. We performed meta-analysis on complication rates using the metaprop library on R studio.
Results:
A total of 2339 studies were retrieved through our search strategy across five databases. Excluding duplicates, the remaining studies were screened resulting in 88 studies being selected for a full text review. Fifty-six studies were excluded due to a lack of outcome specific data leaving a total of thirty-two studies that were included, amounting to 2747 patients with a mean of 86 patients per study. The overall weighted mean age of patients in our study pool was 12.9 ± 4.1 (95% confidence interval [CI]: 12.8-13.1) years. Mean hospital stay was 2.6 ± 1.9 (95% CI: 2.5-2.7) days. Common complications like transient hypocalcemia or hypoparathyroidism was found in 24% (95% CI: 0.2-0.3, I2 = 91%) and transient laryngeal nerve injury was 2% (95% CI: 0.01-0.02, I2 = 35%) of patients. Permanent hypocalcemia or hypoparathyroidism was found in 3% (95% CI: 0.02-0.04, I2 = 65%) patients. Rare complications included permanent laryngeal nerve injury in 1% (95% CI: 0.00-0.01) and hematoma formation in 1% (95% CI: 0.00-0.01).
Conclusions:
Pediatric thyroid surgery, although safe, has a high risk of transient hypocalcemia or hypoparathyroidism. Other complications remain under 3%.
