Document Detail

Long-term follow-up data may help manage patient and parent expectations for pediatric patients undergoing thyroidectomy.
MedLine Citation:
PMID:  23158186     Owner:  NLM     Status:  MEDLINE    
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.
Lilah F Morris; Steven G Waguespack; Carla L Warneke; Haengrang Ryu; Anita K Ying; Barbara J Anderson; Erich M Sturgis; Gary L Clayman; Jeffrey E Lee; Douglas B Evans; Elizabeth G Grubbs; Nancy D Perrier
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  152     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-19     Completed Date:  2013-01-22     Revised Date:  2014-09-03    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1165-71     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
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MeSH Terms
Child, Preschool
Hypoparathyroidism / diagnosis,  drug therapy,  etiology
Hypothyroidism / blood,  drug therapy,  etiology
Medication Adherence
Parents / psychology*
Postoperative Care
Postoperative Complications
Thyroid Neoplasms / psychology,  surgery*
Thyroidectomy* / adverse effects
Thyrotropin / blood
Thyroxine / therapeutic use
Grant Support
Reg. No./Substance:
9002-71-5/Thyrotropin; Q51BO43MG4/Thyroxine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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