Faculty Collaboration Database

Long-term follow-up data may help manage patient and parent expectations for pediatric patients undergoing thyroidectomy. Surgery 2012 Dec;152(6):1165-71

Date

11/20/2012

Pubmed ID

23158186

DOI

10.1016/j.surg.2012.08.056

Scopus ID

2-s2.0-84869437117 (requires institutional sign-in at Scopus site)   29 Citations

Abstract

BACKGROUND: We investigated the incidence and impact of postoperative complications in children who underwent total thyroidectomy (TTx).

METHODS: The records of all pediatric patients undergoing TTx (2001-2011) at our institution were retrospectively reviewed for the occurrence of biochemical hypothyroidism (thyroid-stimulating hormone >10 mIU/mL), laboratory assessments, and medication nonadherence.

RESULTS: The 74 patients (median age, 12.5 years) had thyroid cancer (differentiated, n = 39; medullary, n = 16) or benign pathology (n = 19; 16 with multiple endocrine neoplasia type 2A). The median postoperative follow-up was 3.2 years; 46 patients (62%) had ≥ 1 year follow-up. Forty-one percent had ≥ 1 period of medication nonadherence; this was not associated with age at TTx (P = .30). Non-treatment-related hypothyroidism occurred in 33% of patients during postoperative year (POY) 1. The number of POY1 laboratory assessments among the 30% of patients with parathyroid dysfunction was more than twice that among patients with normal parathyroid function (median assessments per year 8 vs 3; P < .0001). Forty-four percent of patients/families reported behavioral or physiologic changes; 40% were concomitant with abnormal thyroid function.

CONCLUSION: More than 40% of pediatric patients were unable to fully adhere to postoperative medication regimens, and non-treatment-related hypothyroidism was common. Postoperative hypoparathyroidism doubled the number of laboratory assessments obtained. These data may help families better prepare for TTx sequelae.

Author List

Morris LF, Waguespack SG, Warneke CL, Ryu H, Ying AK, Anderson BJ, Sturgis EM, Clayman GL, Lee JE, Evans DB, Grubbs EG, Perrier ND

Author

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Child, Preschool
Female
Humans
Hypoparathyroidism
Hypothyroidism
Male
Medication Adherence
Parents
Postoperative Care
Postoperative Complications
Thyroid Neoplasms
Thyroidectomy
Thyrotropin
Thyroxine