Impact of central node dissection on postoperative morbidity in pediatric patients with suspected or proven thyroid cancer

• Published in: Surgery 2016-08, Vol.160 (2), p.484-492
• Main Authors: Machens, Andreas, MD, Elwerr, Malik, MD, Thanh, Phuong Nguyen, MD, Lorenz, Kerstin, MD, Schneider, Rick, MD, Dralle, Henning, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Age Factors; Carcinoma - pathology; Carcinoma - surgery; Child; Child, Preschool; Female; Humans; Hypoparathyroidism - epidemiology; Lymph Node Excision; Male; Postoperative Complications - epidemiology; Risk Factors; Surgery; Thyroid Neoplasms - pathology; Thyroid Neoplasms - surgery; Thyroidectomy - adverse effects; Treatment Outcome; Vocal Cord Paralysis - epidemiology
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2016.03.007

Background Pediatric risk factors for postoperative morbidity after central node dissection are ill-defined. Methods This outcome study aimed to evaluate operative morbidity in patients aged ≤18 years after total thyroidectomy with or without central node dissection for suspected or proven thyroid cancer. Results Included were 102 patients with hereditary C-cell hyperplasia, 66 patients with medullary, 60 patients with papillary, and 2 patients with follicular thyroid cancer. In all 230 patients, 131 of whom underwent central node dissection, transient recurrent laryngeal nerve palsy was significantly associated only with central node dissection (100% vs 55%; P  = .010). Transient and permanent hypoparathyroidism were significantly associated with age (means of 11.9 years versus 7.8 years, and 12.9 years versus 8.5 years; P  ≤ .002); central node dissection (80% vs 50%, and 100% vs 54%; P  ≤ .001); and the number of central lymph nodes cleared (means of 12.2 nodes versus 5.4 nodes, and 26.9 nodes versus 5.8 nodes, P