DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida; University of Miami Miller School of Medicine, Miami, Florida.
DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida; University of Miami Miller School of Medicine, Miami, Florida.
J Surg Res. 2023 Mar;283:449-458. doi: 10.1016/j.jss.2022.10.074. Epub 2022 Nov 23.
This study aims to analyze the relative risks for total thyroidectomies by comparing complication rates for total versus partial thyroidectomy in the pediatric population.
We queried the Kids' Inpatient Database (KID) 1997-2012 for all cases of total (n = 3253) or partial (n = 2380) thyroidectomy. We then designed a propensity score matching model and compared total versus partial thyroidectomy based on surgical complications and outcomes.
In our cohort, the median age was 16 years and 79% were females. Those treated at a specialty pediatric hospital or pediatric unit in a general hospital comprised 73% of all patients. The most common indications for surgery were malignancy (46%) and goiter (42%). The most common complications were hypocalcemia and nerve injury with an unweighted incidence of 9% (n = 174) and 3% (n = 57) respectively. When compared to partial thyroidectomy, total thyroidectomy was associated with increased rates of postoperative complications. Additionally, the median length of stay was significantly higher for total thyroidectomy patients.
This is the largest analysis to date comparing outcomes for total versus partial thyroidectomy in the pediatric population. Surgeons should consider the increased rates of hypocalcemia and nerve injury complications when selecting total compared to partial thyroidectomy in children.
本研究旨在通过比较儿童人群中甲状腺全切除术与甲状腺部分切除术的并发症发生率，分析甲状腺全切除术的相对风险。
我们在 1997 年至 2012 年期间，通过 Kids' Inpatient Database (KID) 数据库检索所有甲状腺全切除术（n=3253）或甲状腺部分切除术（n=2380）病例。然后，我们设计了一个倾向评分匹配模型，并根据手术并发症和结果比较了甲状腺全切除术与甲状腺部分切除术。
在我们的队列中，中位年龄为 16 岁，79%为女性。73%的患者在专门的儿科医院或综合医院的儿科病房接受治疗。手术的最常见适应证是恶性肿瘤（46%）和甲状腺肿（42%）。最常见的并发症是低钙血症和神经损伤，未加权发生率分别为 9%（n=174）和 3%（n=57）。与甲状腺部分切除术相比，甲状腺全切除术与术后并发症发生率增加相关。此外，甲状腺全切除术患者的中位住院时间明显更长。
这是迄今为止比较儿童人群中甲状腺全切除术与甲状腺部分切除术的最大规模分析。与甲状腺部分切除术相比，外科医生在选择甲状腺全切除术时应考虑到低钙血症和神经损伤并发症发生率增加的情况。
