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[Morbidity from total thyroidectomy in subjects less than 15 years of age. A multicenter study of 107 cases]
C Proye1, B Carnaille, L Vanhove
1Clinique Chirurgicale Adultes Est, CHRU de Lille, Hôpital Huriez Place de Verdun, France.
Abstract:
In the MEN II (Multiple Endocrine Neoplasia) setting, genetic screening is currently available with a 98% reliability. Therefore, total thyroidectomy has been recommended as early as at 3 years of age for gene-carriers. A nationwide retrospective survey has been conducted over 5 years, dealing with 107 cases of total thyroidectomy in patients less than 15 years of age to assess the morbidity of this kind of surgery. Currently, permanent morbidity (recurrent nerve palsy and hypocalcemia) amounts to 1 and 1% of cases respectively. It is observed only when node clearance is deemed to be mandatory. Mortality was zero. In published series (4 overall, from 1972 through 1995), rates seemed to be more important: 11 and 13% respectively, with 1% mortality. These numbers relate to surgery with advanced cancers, often locally invasive. Prophylactic total thyroidectomy morbidity draws near the results of our study. These numbers can argue for the interest of a "prophylactic" total thyroidectomy, before advanced thyroid disease, as a treatment for MTC gene-carriers children and teenagers.