Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 12:14:1301191.
doi: 10.3389/fendo.2023.1301191. eCollection 2023.

Thyroid diseases in children and adolescents requiring surgical treatment-indications, techniques, results, and complications based on 10 years of the single center's own experience

Patrycja Sosnowska-Sienkiewicz  1 , Dajana Danielewicz  1 , Danuta Januszkiewicz-Lewandowska  2 , Paulina Rusak  3 , Iwona Anderko  3 , Maciej Rzepecki  3 , Marek Niedziela  4 , Jerzy Harasymczuk  1 , Przemysław Mańkowski  1
Affiliations

Thyroid diseases in children and adolescents requiring surgical treatment-indications, techniques, results, and complications based on 10 years of the single center's own experience

Patrycja Sosnowska-Sienkiewicz et al. Front Endocrinol (Lausanne). .

Abstract

Introduction: Although thyroid abnormalities are observed less frequently in children than in adults, the increased incidence of thyroid cancer makes it mandatory for all pediatric surgeons to be knowledgeable about the disorders of this gland. Thyroid abnormalities can be associated with hyperthyroidism or hypothyroidism and euthyroidism and/or symmetric or asymmetric enlargement of the gland.

Aim: The present study was undertaken to retrospectively analyze the indications, surgical techniques used, results obtained, and complications found in the surgical treatment of thyroid diseases in children and adolescents in a surgical center for the macro-region of western Poland.

Methods: The data of 148 patients undergoing total or partial thyroidectomy between 2013 and 2022 were analyzed from the medical records of the Department of Pediatric Surgery, Traumatology, and Urology of the Medical University of Poznan, Poland.

Results: A total of 95 children underwent subtotal thyroidectomy and 64 underwent total thyroidectomy, of which the procedure was widened to include prophylactic removal of neck lymph nodes in 45 patients. There were 113 girls (76%) in the analyzed group, and the average age of the patients at the time of surgical treatment was 15 years. The average time from the diagnosis of thyroid disease to surgery was 4 months, ranging from 2 weeks to 3 years. Of the 64 patients undergoing total thyroid resection, 35 (54.69%) were diagnosed with thyroid cancer.

Conclusions: Collaboration within a multidisciplinary team ensures optimal surgical outcomes in children and adolescents with thyroid disease. With extreme caution, thyroid removal is a safe procedure with few complications, but the experience of the surgeon performing thyroid surgery in children remains crucial. Despite the absence of such a diagnosis in the first fine-needle aspiration biopsy, the high percentage of thyroid carcinomas in the analyzed group may be because the initial biopsy was performed in a less experienced center, also in terms of histopathological laboratory. Hence, we point out the necessity of performing a repeat fine-needle aspiration biopsy (according to the Bethesda classification) in a more experienced center before the final decision of thyroidectomy.

Keywords: child; complications; outcomes; thyroid gland; thyroidectomy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Types of surgical procedures performed in the analyzed patients.
Figure 2
Figure 2
Percentage distribution of comorbidities in children who have undergone thyroidectomy.
Figure 3
Figure 3
The duration of surgery and the rate of complications.
Figure 4
Figure 4
The duration of surgery and the length of hospitalization.
Figure 5
Figure 5
Thyroidectomy with lymph node resection and duration of surgery.
Figure 6
Figure 6
Thyroidectomy with lymph node resection and length of hospitalization.
See this image and copyright information in PMC

References

    1. Zobel MJ, Padilla BE. Surgical management of benign thyroid disease in children. Semin Pediatr Surg (2020) 29(3):150922. doi: 10.1016/j.sempedsurg.2020.150922 - DOI - PubMed
    1. Francis GL, Waguespack SG, Bauer AJ, Angelos P, Benvenga S, Cerutti JM, et al. . Management guidelines for children with thyroid nodules and differentiated thyroid cancer. Thyroid. (2015) 25(7):716–59. doi: 10.1089/thy.2014.0460 - DOI - PMC - PubMed
    1. Ledbetter DJ. Thyroid surgery in children. Semin Pediatr Surg (2014) 23(2):60–5. doi: 10.1053/j.sempedsurg.2014.03.002 - DOI - PubMed
    1. Stefan AI, Piciu A, Mester A, Apostu D, Badan M, Badulescu CI. Pediatric thyroid cancer in europe: an overdiagnosed condition? A literature review. Diagnostics (Basel). (2020) 10(2):112. doi: 10.3390/diagnostics10020112 - DOI - PMC - PubMed
    1. Jasim S, Dean DS, Gharib H. Fine-needle aspiration of the thyroid gland. In: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, et al., editors. Endotext. South Dartmouth (MA: MDText.com, Inc; (2000). Available at: https://www.ncbi.nlm.nih.gov/books/NBK285544/. - PubMed