Clinical and Economic Outcomes of Thyroid and Parathyroid Surgery in Children

Sosa, Julie Ann; Tuggle, Charles T.; Wang, Tracy; Thomas, Daniel C.; Boudourakis, Leon; Rivkees, Scott A.; Roman, Sanziana A.

doi:10.1210/jc.2008-0660

Cited by 301 publications

(231 citation statements)

References 25 publications

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“…In the largest study of pediatric DTCs, Demidchik found a complication rate of 22%, including permanent recurrent nerve damage in 6.2% and permanent hypoparathyroidism in 12.3% [39]. Children have higher endocrine-specific complication rates than adults after thyroidectomy (9.1 vs. 6.3%) [43].…”

Section: Treatment -Surgerymentioning

confidence: 99%

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Pediatric Thyroid Cancers: An Indian Perspective

Chaukar

Vaidya

2012

Indian J Surg Oncol

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Pediatric thyroid cancer is a rare entity accounting for less than 5% of all thyroid cancers. This intriguing disease is characterized by advanced presentation, coupled with frequent lymph nodal metastases and often pulmonary metastases. It perhaps exhibits a distinct biology and behaviour, because in spite of its aggressiveness, survival is extremely good. This mandates meticulous treatment decisions that are well executed, because the complications of therapy in patients with good survival may spell prolonged morbidity. Being an unusual disease, it is unlikely that level I evidence guiding the management will come forth. There have been controversies regarding management, and the current consensus comes from large prospective studies. There have been only a few studies from India detailing pediatric thyroid cancers. In the current discussion, we review the existing evidence about pediatric thyroid cancers, and try to have an Indian perspective at the problem.

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Section: Treatment -Surgerymentioning

confidence: 99%

“…Hence it is recommended that these surgeries be performed by high-volume thyroid surgeons (defined as performing more than 30 thyroid surgeries per year) to minimise complications [6,7,43], which may still occur in about 6% of cases [43].…”

Section: Treatment -Surgerymentioning

confidence: 99%

Pediatric Thyroid Cancers: An Indian Perspective

Chaukar

Vaidya

2012

Indian J Surg Oncol

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“…Complications, such as hypoparathyroidism, vocal cord palsy due to recurrent laryngeal nerve injury and keloid formation, may occur with an estimated incidence of approximately 15%, although such complications are less frequent if the operation is performed by pediatric surgeons with extensive experience (18). For patients with recurrent hyperthyroidism after surgery, treatment with RAI is recommended, because the risk of complications is higher for a second operation (19).…”

Section: Introductionmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Arguments for the prolonged use of antithyroid drugs in children with Graves’ disease

Léger

Carel

2017

European Journal of Endocrinology

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Graves' disease is an autoimmune disorder. It is the leading cause of hyperthyroidism, but is rare in children. Patients are initially managed with antithyroid drugs (ATDs), such as methimazole/carbimazole. A major disadvantage of treatment with ATD is the high risk of relapse, exceeding 70% of children treated for duration of 2 years, and the potential major side effects of the drug reported in exceptional cases. The major advantage of ATD treatment is that normal homeostasis of the hypothalamus-pituitary-thyroid axis may be restored, with periods of drug treatment followed by freedom from medical intervention achieved in approximately 40-50% of cases after prolonged treatment with ATD, for several years, in recent studies. Alternative ablative treatments such as radioactive iodine and, less frequently and mostly in cases of very high volume goiters or in children under the age of 5 years, thyroidectomy, performed by pediatric surgeons with extensive experience should be proposed in cases of noncompliance, intolerance to medical treatment or relapse after prolonged medical treatment. Ablative treatments are effective against hyperthyroidism, but they require the subsequent administration of levothyroxine throughout the patient's life. This review considers

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“…Debido al mayor riesgo de malignidad en los NTP, suele preferirse el tratamiento quirúrgico como primera aproximación a esta patología, considerando de manera limitada el aporte de la PAF, en gran parte debido a la falta de consenso sobre el uso de esta técnica en pediatría. Sin embargo, el tratamiento quirúr- gico en esta edad presenta una mayor incidencia de complicaciones que en adultos, especialmente a menor edad del paciente 14 . Las complicaciones incluyen la injuria del nervio laríngeo recurrente (0 a 40%) e hipoparatiroidismo permanente (0 a 32%), las que disminuyen si el procedimiento es realizado por un cirujano de alto volumen, definido como aquel que realiza más de 30 cirugías tiroideas al año 14 .…”

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“…Sin embargo, el tratamiento quirúr- gico en esta edad presenta una mayor incidencia de complicaciones que en adultos, especialmente a menor edad del paciente 14 . Las complicaciones incluyen la injuria del nervio laríngeo recurrente (0 a 40%) e hipoparatiroidismo permanente (0 a 32%), las que disminuyen si el procedimiento es realizado por un cirujano de alto volumen, definido como aquel que realiza más de 30 cirugías tiroideas al año 14 . Para que la citología tiroidea por PAF sea adecuada en la población pediátrica, es necesaria la cooperación del paciente para que la punción sea precisa, por esta razón frecuentemente se realiza bajo sedación.…”

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