Original CommunicationPredicting hypocalcemia after thyroidectomy in children
Section snippets
Patients and methods
We performed a prospective, longitudinal, cohort study. The study protocol was approved by the Institutional Review Board and Ethics Committee of the Hospital de Niños Dr Ricardo Gutierrez. Informed consent was obtained from parents and assent was obtained for children >7 years old; children of all ages were included in the study.
We included consecutively pediatric patients who underwent total thyroidectomy between October 2006 and March 2013 at our hospital. Exclusion criteria were patients
Results
Thirty-five patients underwent total thyroidectomy during the study period. Three patients were excluded: One was under octreotide treatment and the other 2 owing to pronounced deviations from protocol design. Of the remaining 32 patients, 22 were females and 10 males, aged 3.2–17.6 years (median, 11; Table I). Diagnoses that prompted thyroidectomy were prophylactic thyroidectomy in patients with proto-oncogene RET mutation associated with multiple endocrine neoplasia 2A (n = 9), thyroid
Discussion
To our knowledge, this is the first study that assessed the diagnostic performance of intra and postoperative measurements of PTH as a predictor post-thyroidectomy hypocalcemia in a pediatric population. In this pediatric cohort, hypocalcemia developed in 47% of thyroidectomized patients, which is greater than the reported frequency of 20–30% in adults.14 This finding could be owing to greater susceptibility within the pediatric population or to the difficulties inherent to pediatric neck
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Cited by (32)
Does preoperative calcium and 1, 25 OH vitamin D supplementation impact postoperative hypocalcemia and length of stay following pediatric thyroidectomy?
2024, International Journal of Pediatric OtorhinolaryngologyOutcomes in pediatric total thyroidectomy following implementation of a two-surgeon operative approach
2023, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :LOS >1d secondary to hypocalcemia was determined by reviewing clinical note documentation by the primary surgical team, laboratory calcium values, and changes to supplementation regimen made during admission. Permanent hypoparathyroidism was defined as hypocalcemia that required calcium and/or calcitriol supplementation at least 6 months postoperatively, which is consistent with the literature [1,5–8]. The multidisciplinary thyroid team continued to monitor all cases on supplementation for recovery further.
Short-term pediatric thyroidectomy outcome: Analysis of the Pediatric Health Information System (PHIS) database
2022, International Journal of Pediatric OtorhinolaryngologyHypoparathyroidism after thyroidectomy: A 20-year experience at a children's hospital
2022, Endocrinologia, Diabetes y NutricionRisk factors for the development of hypocalcemia in pediatric patients after total thyroidectomy – A systematic review
2021, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :However, this study did not examine transient hypocalcemia and the majority (78%) of surgeries were performed for hyperthyroidism. Similarly, Freire and colleagues[3] reported no association between postoperative hypocalcemia and indications for surgery, patient age and sex, although multivariate analyses were not performed. While Jiang and colleagues also reported no association between the patients’ age, sex or indication for surgery (benign versus malignant) with the incidence of hypocalcemia, they found that patients who underwent total thyroidectomy were more likely to develop hypocalcemia than those who underwent a completion thyroidectomy (total 71.9% versus completion 16.7%, p = 0.01).
Intraoperative parathyroid hormone measurement facilitates outpatient thyroidectomy in children
2021, American Journal of Surgery