Pediatric thyroidectomy: a collaborative surgical approach

J Pediatr Surg. 2011 May;46(5):823-8. doi: 10.1016/j.jpedsurg.2011.02.013.

Abstract

Introduction: We have developed a collaborative approach to pediatric thyroid surgery, with operations performed at a children's hospital by a pediatric surgeon and an endocrine surgeon. We hypothesize that this strategy minimizes specialist-specific limitations and optimizes care of children with surgical thyroid disease.

Methods: Data from all partial and total thyroidectomies performed by the pediatric-endocrine surgery team at a tertiary children's hospital between 1995 and 2009 were collected and analyzed retrospectively. Statistical analyses were performed with IBM SPSS software (SPSS, Chicago, IL).

Results: Thirty-five children met the inclusion criteria (69% female; median age, 13 years; median follow-up, 1119 days). The indications for operation were thyroid nodule (71%), genetic abnormality with predisposition to thyroid malignancy (17%), multinodular goiter (5.7%), Grave disease (2.9%), and Hashimoto thyroiditis (2.9%). Sixteen children (46%) underwent thyroid lobectomy, and 19 children (54%) underwent total thyroidectomy. Median length of stay was 1 day (1 day after lobectomy vs 2 days after total thyroidectomy, P < .0001). There were 4 cases of transient hypocalcemia after total thyroidectomy, but there were no nerve injuries or other in-hospital complications in either group (overall complication rate, 11%).

Conclusions: For pediatric thyroidectomy and thyroid lobectomy, collaboration of high-volume endocrine and pediatric surgeons as well as pediatric endocrinologists at a dedicated pediatric medical center provides optimal surgical outcomes.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Colorado / epidemiology
  • Cooperative Behavior
  • Endocrinology*
  • Female
  • General Surgery*
  • Hospitals, Pediatric / statistics & numerical data
  • Hospitals, University / statistics & numerical data
  • Humans
  • Interdisciplinary Communication
  • Male
  • Medical Oncology
  • Neoplastic Syndromes, Hereditary / surgery
  • Patient Care Team*
  • Pediatrics*
  • Perioperative Care / methods*
  • Postoperative Complications / epidemiology
  • Radiology
  • Retrospective Studies
  • Specialties, Surgical / methods*
  • Thyroid Diseases / surgery
  • Thyroid Neoplasms / surgery
  • Thyroid Nodule / surgery
  • Thyroidectomy / methods*
  • Young Adult