Initial outcomes at a nascent tertiary pediatric thyroid surgical center.

Autor: Bruss DM; California Northstate University, College of Medicine, Elk Grove, CA, 95757, United States; University of California, Irvine School of Medicine, Department of Otolaryngology- Head and Neck Surgery, Orange, CA, 92868, United States; CHOC Children's Hospital of Orange County, Division of Pediatric Otolaryngology- Head and Neck Surgery, Orange, CA, 92868, United States., Kovacs AJ; University of California, Irvine School of Medicine, Department of Otolaryngology- Head and Neck Surgery, Orange, CA, 92868, United States., Kashmiri H; CHOC Children's Hospital of Orange County, Division of Pediatric Endocrinology, Orange, CA, 92868, United States., Huoh KC; University of California, Irvine School of Medicine, Department of Otolaryngology- Head and Neck Surgery, Orange, CA, 92868, United States; CHOC Children's Hospital of Orange County, Division of Pediatric Otolaryngology- Head and Neck Surgery, Orange, CA, 92868, United States. Electronic address: kevinhuoh@gmail.com.
Jazyk: angličtina
Zdroj: International journal of pediatric otorhinolaryngology [Int J Pediatr Otorhinolaryngol] 2021 Apr; Vol. 143, pp. 110639. Date of Electronic Publication: 2021 Feb 02.
DOI: 10.1016/j.ijporl.2021.110639
Abstrakt: Objectives: Previous studies on pediatric thyroid surgical complications suggest that high-volume centers achieve improved outcomes. We hypothesize that initial outcomes from a nascent pediatric surgical practice may be comparable to higher volume centers. Furthermore, we determine whether a low-volume center can safely transition to an intermediate or high-volume center.
Methods: A retrospective chart review was performed for all pediatric patients undergoing thyroid surgery at a single institution from 2014 to 2020. Surgeries were performed by two pediatric otolaryngologists. All patients were managed postoperatively by a multidisciplinary team of physicians that included pediatric otolaryngologists and endocrinologists. Data collection focused on patient demographics and postoperative complications, including rates of recurrent laryngeal nerve injury and permanent hypoparathyroidism.
Results: From 2014 to 2020, a total of 31 patients underwent thyroid surgery at our pediatric thyroid surgery center, 9 of whom underwent neck dissection. The mean age of our cohort was 14.4 ± 3.9 years (range 8 months-20 years). Postoperative pathology results revealed that 15 patients (46.9%) were diagnosed with PTC, 6 (18.8%) with follicular adenoma, and 4 (15.6%) with benign thyroid tissue. One (2.0%) patient had permanent unilateral recurrent laryngeal nerve paralysis and one patient experienced permanent hypoparathyroidism (2.7%).
Conclusions: Our initial low complication rate as a nascent pediatric thyroid surgery center suggests that favorable outcomes can be achieved at lower volume surgery centers. In order to increase patient access to high-volume pediatric thyroid surgery centers, new centers must start with lower volumes before ultimately becoming high-volume centers. Our study shows that this can be safely achieved.
Level of Evidence: IV.
(Copyright © 2021 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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