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      Pediatric thyroidectomy: a collaborative surgical approach.

      Journal of Pediatric Surgery
      Adolescent, Child, Child, Preschool, Colorado, epidemiology, Cooperative Behavior, Endocrinology, Female, General Surgery, Hospitals, Pediatric, statistics & numerical data, Hospitals, University, Humans, Interdisciplinary Communication, Male, Medical Oncology, Neoplastic Syndromes, Hereditary, surgery, Patient Care Team, Pediatrics, Perioperative Care, methods, Postoperative Complications, Radiology, Retrospective Studies, Specialties, Surgical, Thyroid Diseases, Thyroid Neoplasms, Thyroid Nodule, Thyroidectomy, Young Adult

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          Abstract

          We have developed a collaborative approach to pediatric thyroid surgery, with operations performed at a children's hospital by a pediatric surgeon and an endocrine surgeon. We hypothesize that this strategy minimizes specialist-specific limitations and optimizes care of children with surgical thyroid disease. Data from all partial and total thyroidectomies performed by the pediatric-endocrine surgery team at a tertiary children's hospital between 1995 and 2009 were collected and analyzed retrospectively. Statistical analyses were performed with IBM SPSS software (SPSS, Chicago, IL). Thirty-five children met the inclusion criteria (69% female; median age, 13 years; median follow-up, 1119 days). The indications for operation were thyroid nodule (71%), genetic abnormality with predisposition to thyroid malignancy (17%), multinodular goiter (5.7%), Grave disease (2.9%), and Hashimoto thyroiditis (2.9%). Sixteen children (46%) underwent thyroid lobectomy, and 19 children (54%) underwent total thyroidectomy. Median length of stay was 1 day (1 day after lobectomy vs 2 days after total thyroidectomy, P < .0001). There were 4 cases of transient hypocalcemia after total thyroidectomy, but there were no nerve injuries or other in-hospital complications in either group (overall complication rate, 11%). For pediatric thyroidectomy and thyroid lobectomy, collaboration of high-volume endocrine and pediatric surgeons as well as pediatric endocrinologists at a dedicated pediatric medical center provides optimal surgical outcomes. Copyright © 2011 Elsevier Inc. All rights reserved.

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