Virginie Bussières1, Shreyas Roy2, Johnny Deladoey3, Élisabeth Rousseau4, Dickens St-Vil2, Nelson Piché5. 1. Faculty of Medicine, University of Montreal, Montreal, Qc, Canada. 2. Faculty of Medicine, University of Montreal, Montreal, Qc, Canada; Department of Surgery, Division of Pediatric Surgery, CHU Sainte-Justine, Montreal, Qc, Canada. 3. Department of Pediatrics, Division of Pediatric Endocrinology, CHU Sainte-Justine, Montreal, Qc, Canada. 4. Faculty of Medicine, University of Montreal, Montreal, Qc, Canada; Department of Pediatrics, CHU Sainte-Justine, Montreal, Qc, Canada. 5. Faculty of Medicine, University of Montreal, Montreal, Qc, Canada; Department of Surgery, Division of Pediatric Surgery, CHU Sainte-Justine, Montreal, Qc, Canada. Electronic address: n.piche@umontreal.ca.
Abstract
AIM OF THE STUDY: Recent publications suggest pediatric surgeons may not be well suited to perform thyroid surgeries unless considered high volume. We sought to assess the outcome of thyroidectomies performed by pediatric surgeons in an academic setting. METHODS: We reviewed charts of patients younger than 18 years who underwent thyroid surgeries at a free standing children's hospital between April 2006 and October 2015. MAIN RESULTS: The analysis included 118 surgeries in 98 patients (mean age 11.8 years). Most surgeries were performed by a single pediatric surgeon (average 10 thyroidectomies per year). The commonest indication for resection was thyroid nodule (64%). 80% of patients had a single surgery; the remainder had two, including 13 completion hemithyroidectomies. Cancer was found in 37% of specimens, with papillary subtype being most common (72%). Seven patients had locoregional metastases and one had pulmonary metastases. Among the 17 malignant cases that had a second intervention, 6 had malignancy in the resected specimen. There were no deaths in the follow up period (mean 2.7 years). Two patients had permanent hypocalcemia, and three had persistent unilateral recurrent laryngeal nerve injuries causing dysphonia for a total permanent complication rate of 4.2%. CONCLUSIONS: We conclude that pediatric thyroidectomy is a safe procedure when performed by pediatric surgeons. Our rate of complications is comparable to those reported in the literature. Our data highlight the need for a vigilant and multidisciplinary approach for children with thyroid pathology. TYPE OF STUDY: Treatment study. LEVEL OF EVIDENCE: IV.
AIM OF THE STUDY: Recent publications suggest pediatric surgeons may not be well suited to perform thyroid surgeries unless considered high volume. We sought to assess the outcome of thyroidectomies performed by pediatric surgeons in an academic setting. METHODS: We reviewed charts of patients younger than 18 years who underwent thyroid surgeries at a free standing children's hospital between April 2006 and October 2015. MAIN RESULTS: The analysis included 118 surgeries in 98 patients (mean age 11.8 years). Most surgeries were performed by a single pediatric surgeon (average 10 thyroidectomies per year). The commonest indication for resection was thyroid nodule (64%). 80% of patients had a single surgery; the remainder had two, including 13 completion hemithyroidectomies. Cancer was found in 37% of specimens, with papillary subtype being most common (72%). Seven patients had locoregional metastases and one had pulmonary metastases. Among the 17 malignant cases that had a second intervention, 6 had malignancy in the resected specimen. There were no deaths in the follow up period (mean 2.7 years). Two patients had permanent hypocalcemia, and three had persistent unilateral recurrent laryngeal nerve injuries causing dysphonia for a total permanent complication rate of 4.2%. CONCLUSIONS: We conclude that pediatric thyroidectomy is a safe procedure when performed by pediatric surgeons. Our rate of complications is comparable to those reported in the literature. Our data highlight the need for a vigilant and multidisciplinary approach for children with thyroid pathology. TYPE OF STUDY: Treatment study. LEVEL OF EVIDENCE: IV.