Thyroid surgery outcomes at a Children's Hospital: The value of a multidisciplinary team approach.

Published on Jul 7, 2021in Journal of Pediatric Surgery2.545
· DOI :10.1016/J.JPEDSURG.2021.06.010
David E. Wesson47
Estimated H-index: 47
(BCM: Baylor College of Medicine),
Brittany L. Johnson4
Estimated H-index: 4
(BCM: Baylor College of Medicine)
+ 11 AuthorsJ. Hernandez5
Estimated H-index: 5
(Boston Children's Hospital)
Sources
Abstract
Abstract null null Background null Our purpose is to describe the structure, function and outcomes of our multidisciplinary pediatric thyroid program and to evaluate our experience in comparison to other high-volume centers. null null null Methods null We reviewed all thyroid operations performed 10/2012 through 09/2019, and examined number of cases per year, patient demographics, procedures, final diagnoses and results. Primary outcomes were hypoparathyroidism and recurrent laryngeal nerve (RLN) injury at 12 months. Data were analyzed using descriptive statistics and univariate analyses. null null null Results null We performed 294 thyroid operations on 279 patients. Seventy-nine percent were female. Median age was 15 years (IQR: 12–17). Operations included total thyroidectomy (65%), lobectomy (30%) and completion thyroidectomy (5%). Most common diagnoses were Graves’ disease (35%), malignancy (29%), and benign nodule (20%). We developed an evidence-based clinical pathway and conducted weekly multidisciplinary meetings. A clinical data specialist reviewed process and outcome measures routinely. Overall, 6 patients (2.0%) had hypoparathyroidism and 2 (0.7%) had unilateral RLN injury at 12 months. Two of the patients with clinical suspicion of permanent hypoparathyroidism were ultimately weaned off calcium. Both patients with RLN injury had extensive locally advanced malignant disease involving the nerve. null null null Conclusions null Our multidisciplinary team achieved excellent long-term outcomes for pediatric thyroid surgery comparable to other high-volume pediatric and adult centers. null Level of Evidence IV
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Abstract Objective This study aims to establish the typical population, safety, and outcomes of pediatric thyroidectomies, specifically identifying surgical complication rates. Furthermore, the study compares management and complication differences between the two specialties that most often manage these patients - Pediatric General Surgery and Otolaryngology. Methods National Surgical Quality Improvement Program – Pediatrics (NSQIP-P) data between the years of 2012 and 2016 was reviewed and ana...
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The core function of a multidisciplinary team (MDT) is to bring together a group of healthcare professionals from different fields in order to determine patients' treatment plan. Most of head and neck cancer (HNC) units are currently led by MDTs that at least include ENT and maxillofacial surgeons, radiation and medical oncologists. HNC often compromise relevant structures of the upper aerodigestive tract involving functions such as speech, swallowing and breathing, among others. The impairment ...
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This study uses South Korean administrative database data to assess changes in incidence of postthyroidectomy hypoparathyroidism during a period of fluctuations in thyroid cancer screening and surgery between 2007 and 2016.
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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 (mea...
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Abstract Purpose We seek to identify risk factors associated with hypocalcemia after pediatric total thyroidectomy. Methods We retrospectively reviewed patients younger than 21years undergoing total thyroidectomy between January 2002 and January 2016. We defined hypocalcemia as any serum calcium Results Ninety-one children underwent total thyroidectomy. The average age was 13.7±4.4years, and 77% were female. Transient hypocalcemia was diagnosed in 34% (n=31) of patients. There was one case of pe...
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AbstractRecurrent laryngeal nerve (RLN) injury is a feared complication after thyroid and parathyroid surgery. It induces important postoperative morbidity. The present study aimed to assess the incidence of transient/permanent postoperative RLN injuries after thyroid and parathyroid surgery in the
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