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)
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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#2Sina J. Torabi (Yale University)H-Index: 9
Last. Erik Waldman (Yale University)H-Index: 2
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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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Last. Ricard MesiaH-Index: 30
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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 ...
#1Song Vogue Ahn (Ewha Womans University)H-Index: 1
#2Joon Hyop Lee (Gachon University)H-Index: 9
Last. Sihoon Lee (Gachon University)H-Index: 16
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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.
#1Sherene Shalhub (UW: University of Washington)H-Index: 17
#2Peter H. Byers (UW: University of Washington)H-Index: 93
Last. Karen Woo (UCLA: University of California, Los Angeles)H-Index: 19
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#1Heron D. Baumgarten (UPenn: University of Pennsylvania)H-Index: 7
Abstract Background Recent studies suggest improved outcomes for children undergoing thyroidectomy at high-volume pediatric surgery centers. We present outcomes after thyroid surgery at a single center and advocate for referral to high-volume centers for multidisciplinary management of these children. Methods Medical records were reviewed for all pediatric patients undergoing thyroid surgery at a single institution from 2009 through 2017. Routine recurrent laryngeal nerve and parathyroid hormone...
#1Virginie Bussières (UdeM: Université de Montréal)H-Index: 2
#2Shreyas Roy (UdeM: Université de Montréal)H-Index: 2
Last. Nelson Piché (UdeM: Université de Montréal)H-Index: 9
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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...
#1Thomas D. Shellenberger (University of Texas MD Anderson Cancer Center)H-Index: 11
#2Randal S. Weber (University of Texas MD Anderson Cancer Center)H-Index: 96
: The multidisciplinary team planning conference is critical in the evaluation and management of patients with head and neck cancer. The management is complex and dictates the care of a multidisciplinary team for optimal results. First, the head and neck multidisciplinary team ensures the complete evaluation of patients before beginning treatment. Second, the team improves the accuracy of diagnosis and staging on which to base the most appropriate treatment. Third, the team improves the outcomes...
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#2Sarah WallaceH-Index: 6
Last. Brendan McGrath (University Hospital of South Manchester NHS Foundation Trust)H-Index: 21
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#2Sara C. Fallon (BCM: Baylor College of Medicine)H-Index: 20
Last. Monica E. Lopez (BCM: Baylor College of Medicine)H-Index: 20
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#2Valentine GuarneroH-Index: 3
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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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