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Función Tiroidea Después de Hemitiroidectomía en Niños

Yamini Adusumelli1, Carter R Petty2, Christine E Cherella3

  • 1Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.

Thyroid : official journal of the American Thyroid Association
|December 30, 2025
PubMed
Resumen
Este resumen es generado por máquina.

Los niños que se someten a una hemotiroidectomía tienen un riesgo del 27,5 % de desarrollar hipotiroidismo en los cinco años posteriores a la cirugía, que a menudo se manifiesta en el primer año. Los niveles preoperatorios de TSH y los anticuerpos TPO ayudan a identificar a los pacientes pediátricos de alto riesgo.

Palabras clave:
hipotiroidismolobectomíapediátricocirugía

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Área de la Ciencia:

  • Endocrinología Pediátrica
  • Cirugía Pediátrica
  • Tiroideología

Sus antecedentes:

  • La incidencia y los factores predictivos de hipotiroidismo después de la hemotiroidectomía en pacientes pediátricos no están bien establecidos.
  • Comprender estos riesgos es crucial para optimizar la atención posoperatoria y el asesoramiento al paciente en la cirugía tiroidea pediátrica.

Objetivo del estudio:

  • Determinar la incidencia de hipotiroidismo después de la hemotiroidectomía en niños.
  • Identificar los factores clínicos asociados con un mayor riesgo de hipotiroidismo posoperatorio.

Principales métodos:

  • Estudio de cohorte retrospectivo de 136 pacientes pediátricos (<19 años) sometidos a hemotiroidectomía.
  • Análisis de la función tiroidea posoperatoria y el estado del tratamiento con levotiroxina (LT4).
  • Se utilizó análisis de supervivencia univariable/multivariable y regresión logística para evaluar los factores de riesgo.

Principales resultados:

  • El riesgo a 5 años de hipotiroidismo persistente o tratamiento con LT4 (PersHypo/LT4) fue del 27,5 %.
  • La TSH preoperatoria ≥ 2 mIU/L se asoció con un riesgo significativamente mayor a 5 años (58,8 % frente a 12,8 %).
  • Los anticuerpos anti-tiroperoxidasa (TPO) se asociaron de forma independiente con un mayor riesgo de PersHypo/LT4 (OR: 7,37).

Conclusiones:

  • El hipotiroidismo persistente o el tratamiento con LT4 afecta a más de una cuarta parte de los niños en los 5 años posteriores a la hemotiroidectomía, principalmente en el primer año.
  • Los niveles preoperatorios de TSH y el estado de los anticuerpos TPO pueden estratificar a los pacientes pediátricos en grupos de bajo y alto riesgo de desarrollar hipotiroidismo.
  • Los hallazgos guían las estrategias de asesoramiento preoperatorio y seguimiento posoperatorio para pacientes pediátricos sometidos a hemotiroidectomía.