Pediatric thyroidectomy in a high volume thyroid surgery center: Risk factors for postoperative hypocalcemia

Chen, Yufei; Masiakos, Peter T.; Gaz, Randall D.; Hodin, Richard A.; Parangi, Sareh; Randolph, Gregory W.; Sadow, Peter M.; Stephen, Antonia E.

doi:10.1016/j.jpedsurg.2014.10.056

Cited by 74 publications

(103 citation statements)

References 23 publications

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“…This study suggests that pediatric patients undergoing thyroidectomy with neck dissection may have a higher rate of hypocalcemia. This supports the results of a multivariate analysis that shows that central and bilateral lymph node dissection and the presence of malignancy are independent predictors of postoperative hypocalcemia in the pediatric population [8]. The high rate of transient hypocalcemia in the pediatric population underscores the importance of postoperative electrolyte management in this population.…”

Section: Accepted Manuscript #12supporting

confidence: 83%

“…Transient hypocalcemia is believed to be caused by transient disruption of the blood supply to the parathyroid glands or removal of one or more glands. Hypocalcemia is the most common complication after thyroidectomy surgery and is often the cause of prolonged hospital stay and significant morbidity [8]. The largest series of pediatric thyroidectomy patients demonstrate transient hypocalcemia rates ranging from 13% to 47% and permanent hypocalcemia rates of 0.9% to 8% [8][9][10][11].…”

Section: Accepted Manuscript #6mentioning

confidence: 99%

“…Hypocalcemia is the most common complication after thyroidectomy surgery and is often the cause of prolonged hospital stay and significant morbidity [8]. The largest series of pediatric thyroidectomy patients demonstrate transient hypocalcemia rates ranging from 13% to 47% and permanent hypocalcemia rates of 0.9% to 8% [8][9][10][11]. Pediatric patients with temporary or permanent hypoparathyroidism have more than twice as many laboratory assessments during the first postoperative year compared to patients with normal postoperative parathyroid function [11].…”

Section: Accepted Manuscript #6mentioning

confidence: 99%

See 2 more Smart Citations

A clinical pathway for the postoperative management of hypocalcemia after pediatric thyroidectomy reduces blood draws

Patel

Bly

Adams

et al. 2018

International Journal of Pediatric Otorhinolaryngology

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Section: Accepted Manuscript #12supporting

confidence: 83%

Section: Accepted Manuscript #6mentioning

confidence: 99%

Section: Accepted Manuscript #6mentioning

confidence: 99%

See 1 more Smart Citation

A clinical pathway for the postoperative management of hypocalcemia after pediatric thyroidectomy reduces blood draws

Patel

Bly

Adams

et al. 2018

International Journal of Pediatric Otorhinolaryngology

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“…Si bien la cirugía de tiroides tiene complicaciones potenciales, es de baja frecuencia en diferentes series, sólo en dos casos se presentó una hipocalcemia transitoria y un mismo caso tuvo hipocalcemia permanente con parálisis de ambas cuerdas vocales que requirió traqueostomía, el cual fue intervenido posteriormente por disección cervical bilateral (15) .…”

Section: Procedimiento Quirúrgicounclassified

“…La tiroidectomía total tiene indicaciones para patología benigna y es imperativa para patología maligna, debido a que su objetivo es la remoción total de la glándula, la cual puede tener focos microscópicos de cáncer en el lóbulo contralateral además de ofrecer un mejor control tanto en el tratamiento hormonal, el tratamiento ablativo con iodo radioactivo, y la realización del seguimiento con tiroglobulina sérica para recurrencia tumoral; desde luego con la remoción de los ganglios comprometidos a través de una disección cervical ganglionar. Mientras que el tratamiento de tiroidectomía parcial (hemitiroidectomía o subtotal) si bien es menos agresivo, no permite cumplir con lo descrito anteriormente (1,4,15) .…”

Section: Introductionunclassified

Patologia quirúrgica de la glándula tiroides en pacientes pediátricos

2019

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Introducción. La patología quirúrgica que comprende a la glándula tiroides en pacientes pediátricos es poco frecuente, pero de presentarse se debe considerar la posibilidad de neoplasias malignas que es más probable en la edad pediátrica. Objetivo. Describir las características pre y post quirúrgicas de los pacientes pediatricos operados de glándula tiroides. Métodos. Se revisaron las historias clínicas de los pacientes intervenidos quirúrgicamente con patología quística, neoplásica o inflamatoria de la glándula tiroides entre enero del 2008 a enero del 2017. Resultados. Se intervinieron 60 casos, siendo el sexo femenino el predominante con el 80% de los casos y el 56,6% entre 13 a 16 años. Las neoplasias benignas correspondieron al 51,7% del total. La cirugía más realizada fue la hemitiroidectomía con el 60% y en segundo lugar la resección de la glándula remanente para completar la tiroidectomía total. Hubo dos casos con hipocalcemia transitoria, y un caso con hipocalcemia permanente y además parálisis de cuerdas vocales que requirió traqueostomía. Conclusión. El tratamiento de las neoplasias o quistes tiroideos es eminentemente quirúrgico, con una mínima morbilidad y menor mortalidad. Los tumores de la glándula tiroides no son de presentación excepcional en pacientes pediátricos.

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Management of Pediatric Graves Disease

Quintanilla‐Dieck

Khalatbari

Dinauer

et al. 2021

JAMA Otolaryngol Head Neck Surg

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he management of Graves disease (GD) requires integrated participation from multiple disciplines to provide optimal care for patients. Being familiar with the treatment options and their indications will help clinicians ensure optimal care for their patients, which may have positive consequences for quality of life.The incidence of pediatric GD is thought to be rising and varies widely. Prevalence rates have geographic variance worldwide, ranging from 1 case per 10 000 in the US to 1 case per 100 000 in the UK and Ireland and as many as 14 cases per 100 000 in Hong Kong. [1][2][3] Graves disease accounts for 10% to 15% of thyroid disorders during childhood and is much more frequent in female than in male patients. 1,4 This review focuses on the diagnosis and management of GD specifically in children. The evaluation of these patients includes biochemical tests and, possibly, imaging; it is important to know how to interpret these test results and how confident one can be in a diagnosis. The management options-specifically medical therapy, nuclear medicine therapy with radioactive iodine (RAI), or surgical therapy-will be discussed in detail, with a special focus on indications, contraindications, and adverse effects or complications of each modality. MethodsThe purpose of this review is to present a broad perspective on pediatric GD. The authors span a variety of disciplines relevant to the subject of pediatric GD, including otolaryngology-head and neck surgery, pediatric endocrinology, radiology with a focus on nuclear medicine, and ophthalmology. We conducted an extensive literature review and obtained expert opinion where appropriate. We also performed a PubMed literature search to identify the most up-todate and relevant information on the subject using the search terms Graves disease, hyperthyroidism, pediatric, Graves orbitopathy, methimazole, antithyroid drugs, radioactive iodine, and thyroidectomy, individually or in combination. Results DefinitionsThyrotoxicosis is defined by the 2016 American Thyroid Association's (ATA) guidelines as "a clinical state that results from inappro-IMPORTANCE The incidence of Graves disease (GD) is rising in children, and adequate care of these patients requires a multidisciplinary approach. Whether patients are seen in the context of endocrinology, nuclear medicine, or surgery, it is important to know the nuances of the therapeutic options in children.OBSERVATIONS Given the rarity of GD in children, it is important to recognize its various clinical presenting signs and symptoms, as well as the tests that may be important for diagnosis. The diagnosis is typically suspected clinically and then confirmed biochemically. Imaging tests, including thyroid ultrasonography and/or nuclear scintigraphy, may also be used as indicated during care. It is important to understand the indications for and interpretation of laboratory and imaging tools so that a diagnosis is made efficiently and unnecessary tests are not ordered. Clinicians should be well-versed in treatment options to appro...

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Pediatric thyroidectomy in a high volume thyroid surgery center: Risk factors for postoperative hypocalcemia

Cited by 74 publications

References 23 publications

A clinical pathway for the postoperative management of hypocalcemia after pediatric thyroidectomy reduces blood draws

A clinical pathway for the postoperative management of hypocalcemia after pediatric thyroidectomy reduces blood draws

Patologia quirúrgica de la glándula tiroides en pacientes pediátricos

Management of Pediatric Graves Disease

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