T. M. MADKHALI1, A. I. Salem1, D. F. Schneider1, R. S. Sippel1, H. Chen1,2 1University Of Wisconsin-Hospital & Clinics,Endocrine Surgery,Madison, WI, USA 2University Of Alabama,Surgery,Birmingham, Alabama, USA
Introduction: Thyroid disease requiring surgery is relatively rare in children but can have significant life-long health implications. Published data indicates higher postoperative complications following thyroidectomy when compared to the adult population reaching more than 50%. However, this percentage is much less when thyroidectomy is performed in high volume centers. We sought to assess the incidence of postoperative complications in pediatric patients in a high volume thyroid surgery center
Methods: A retrospective review of patients younger than 19 years who underwent thyroidectomy at our institution between July 1994 and July 2014. The primary outcomes were the incidence of postoperative hypocalcemia, hoarseness, hematoma, and surgical site infection. Hypocalcemia was defines as plasma calcium level < 8 mg/dl, parathyroid hormone level < 10 pg/ml, or the need of oral calcium and activated vitamin D (calcitriol) supplementations to prevent hypocalcemia symptoms
Results: While more than 3,290 thyroidectomies were performed on adult patients in our institution, around 126 pediatric patients underwent 131 thyroid operations in the same time frame. For the latter group, the average age was 13 ± 5 years with female gender predominance (77%). Nodular diseases (37%) and hyperthyroidism (34%) were the most common indications for thyroidectomy in pediatric age group. Subtotal/total thyroidectomy was performed in 97 patients (74%). 33 patients developed 35 complications (27%), mainly due to transient hypocalcemia in 28 patients (21%) and transient hoarseness in 5 patients (4%). Only 1 patient (<1%) experienced permanent hypocalcemia. None of the patients developed permanent hoarseness, hematoma, or surgical site infection
Conclusion: In our institution, thyroidectomy in pediatric patients can be considered as a safe procedure with a low postoperative complication rate