Our Summary

This study examined the results and potential complications of thyroid removal surgeries, known as thyroidectomies, in children. The researchers used data from 47 children’s hospitals across the US, looking at surgeries performed on patients 18 years and younger from 2009 to 2019.

The study included 6,405 patients, most of whom were female and between 15-18 years old. The researchers found that children under one year old, and those who were Hispanic or Black, were more likely to experience complications after surgery. Children with other complex chronic conditions also had higher rates of complications.

The most common complication was hypocalcemia, a condition characterized by low calcium levels in the blood, which was seen in 15.6% of patients. The overall complication rate was 27.7%. The study also found that complications were less common in patients with benign or non-specific thyroid nodules compared to those with malignant nodules or Graves’ disease.

A total thyroidectomy (removal of the entire thyroid) was associated with a higher risk of complications than a partial thyroidectomy. Similarly, surgeries involving neck dissections and parathyroid re-implantations were also linked to more complications.

Patients with complications also had longer stays in the hospital (2.4 days versus 1.2 days for those without complications) and higher medical costs.

Interestingly, the number of surgeries a hospital performed did not affect the rate of complications. The researchers suggest that the best performing hospitals’ complication rates could serve as an achievable goal for others to improve their care.

FAQs

  1. What is the most common complication after a thyroidectomy in children?
  2. Does the risk of complications after a thyroidectomy vary based on patient demographics and other health conditions?
  3. Was there a difference in complication rates between total and partial thyroidectomies?

Doctor’s Tip

One helpful tip a doctor might give a patient about thyroidectomy is to carefully follow post-operative instructions, including taking prescribed medications, monitoring calcium levels, and attending follow-up appointments. It is important to communicate any unusual symptoms or concerns to your healthcare provider promptly to ensure proper management of any complications that may arise.

Suitable For

Patients who are typically recommended for thyroidectomy include those with:

  1. Thyroid cancer: Patients with thyroid cancer may undergo a thyroidectomy to remove the cancerous tissue and prevent further spread of the disease.

  2. Benign thyroid nodules: Thyroid nodules that are causing symptoms such as difficulty breathing or swallowing, or are suspicious for cancer, may be recommended for removal through thyroidectomy.

  3. Graves’ disease: Patients with Graves’ disease, an autoimmune disorder that causes an overactive thyroid gland, may undergo thyroidectomy if other treatments are not effective in controlling symptoms.

  4. Large goiters: Enlarged thyroid glands, known as goiters, that are causing symptoms such as difficulty breathing or swallowing may be recommended for removal through thyroidectomy.

  5. Hyperthyroidism: Patients with an overactive thyroid gland that does not respond to medication may be recommended for thyroidectomy to control hormone levels.

  6. Recurrent thyroid nodules: Patients who have recurrent thyroid nodules after previous treatments may be recommended for thyroidectomy.

It is important for patients to discuss their individual case with their healthcare provider to determine if thyroidectomy is the best treatment option for their condition.

Timeline

Before thyroidectomy:

  • Patient undergoes pre-operative evaluations including blood tests, imaging studies, and possibly a fine needle aspiration biopsy to determine the nature of the thyroid nodule or condition
  • The patient may be prescribed medications to optimize thyroid function before surgery
  • The risks and benefits of the surgery are discussed with the patient by the healthcare team

After thyroidectomy:

  • Patient may experience symptoms such as neck pain, difficulty swallowing, hoarseness, and temporary voice changes
  • Patient may need to take thyroid hormone replacement medication for life to maintain normal thyroid function
  • Follow-up appointments with the healthcare team are scheduled to monitor thyroid hormone levels and overall health
  • Patient may undergo radioactive iodine treatment or additional surgeries if the thyroidectomy was done for thyroid cancer
  • Complications such as hypocalcemia, vocal cord paralysis, and infection may occur and require additional treatment and monitoring.

What to Ask Your Doctor

Some questions a patient should ask their doctor about thyroidectomy include:

  1. What are the potential complications and risks associated with thyroid removal surgery?
  2. What factors may increase my risk of experiencing complications during or after the surgery?
  3. Will I need to take any medications or undergo any additional treatments after the surgery?
  4. How long is the recovery process expected to take, and what can I do to help facilitate a smooth recovery?
  5. Are there any specific lifestyle changes or dietary recommendations I should follow post-surgery?
  6. Will I need to have regular follow-up appointments or monitoring of my thyroid function after the surgery?
  7. How experienced is the surgical team in performing thyroidectomies, and what is their success rate in avoiding complications?
  8. Are there any alternatives to thyroidectomy that I should consider before moving forward with the surgery?
  9. What is the expected outcome of the surgery in terms of managing my thyroid condition or addressing any related health concerns?
  10. Can you provide me with information on the hospital’s track record in performing thyroidectomies and managing complications?

Reference

Authors: Jiang W, Hall M, Newfield R, Berry JG. Journal: Int J Pediatr Otorhinolaryngol. 2022 Dec;163:111340. doi: 10.1016/j.ijporl.2022.111340. Epub 2022 Oct 17. PMID: 36274324