Highlights
- •Pediatric general surgeons perform most of the total thyroidectomies in NSQIP-P hospitals.
- •Prolonged hospitalization is more frequent after total thyroidectomy by pediatric ENT.
- •Postoperative readmissions are similar across pediatric and adult surgeons.
- •Opportunities may exist to improve outcomes with respect to resource utilization.
Abstract
Background
Total thyroidectomy (TT) in children is performed by pediatric general surgeons (P-GS),
pediatric otolaryngologists (P-ENT), or adult GS/ENT. This study evaluated short-term
pediatric TT outcomes, focusing on surgical subspecialties.
Methods
Pediatric (<18 years) TT with/without central limited lymph node dissection (CLND)
between 2015 and 2020 were obtained from the National Surgical Quality Improvement
Program-Pediatric database. Risk factors for prolonged hospitalization (PH,>2 days)
and 30-day readmission were investigated with multivariate logistic regression.
Results
Of 1535 patients, 14% had PH and 2% were readmitted. PH rates for P-ENT vs. P-GS vs.
adult were 21% vs. 11% vs. 10%, respectively. Adjusted risk of PH was higher for P-ENT
(OR 1.70, p = 0.003) but similar for P-GS/adult. There was no difference for risk
of readmission by subspecialty.
Conclusion
PH is more likely after pediatric TT performed by P-ENT, as compared to P-GS or adult
surgeons. While TT may be performed safely by individual subspecialties, collaboration
across specialties may further optimize outcomes.
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Article info
Publication history
Published online: October 08, 2022
Accepted:
September 28,
2022
Received in revised form:
September 19,
2022
Received:
April 15,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
