Outcomes of surgical treatment of thyroid disease in children
Background. In recent years there has been a tendency of increase in the proportion of nodular goiter and Graves’ disease in thyroid pathology in children, which necessitates a choice of rational tactics for treatment of these diseases. At present there is no optimal method of treatment for thyroid...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Siberian State Medical University (Tomsk)
2017-10-01
|
| Series: | Бюллетень сибирской медицины |
| Subjects: | |
| Online Access: | https://bulletin.ssmu.ru/jour/article/view/961 |
| _version_ | 1797872877595262976 |
|---|---|
| author | Olga S. Rogova Lubov N. Samsonovа Goar F. Okminyan Elena V. Kiseleva Oleg Yu. Latyshev Elvira P. Kasatkina Mikhail I. Pykov Aleksey B. Okulov Kirill K. Mirakov |
| author_facet | Olga S. Rogova Lubov N. Samsonovа Goar F. Okminyan Elena V. Kiseleva Oleg Yu. Latyshev Elvira P. Kasatkina Mikhail I. Pykov Aleksey B. Okulov Kirill K. Mirakov |
| author_sort | Olga S. Rogova |
| collection | DOAJ |
| description | Background. In recent years there has been a tendency of increase in the proportion of nodular goiter and Graves’ disease in thyroid pathology in children, which necessitates a choice of rational tactics for treatment of these diseases. At present there is no optimal method of treatment for thyroid gland pathology, but one of the methods is surgery. Thyroid surgery due to the determination of the indications and choice of the optimal volume of the surgical intervention continues to be under debate as postoperative complications of surgical treatment of thyroid diseases in children are possible.Aim: to study the outcomes of surgical treatment for thyroid pathology in children, depending on the volume of operation.Materials and methods. This article presents the results of a survey of 77 children operated on in the period of 2002–2016 for Graves’ disease, single-node goiter, and multinodular goiter. The examination included the determination of the levels of ionized calcium and TSH, FT4, FT3 in the blood serum, the evaluation of the functional state of the pituitary-thyroid system, thyroid ultrasound examination, and examination by an otolaryngologist.Results. The incidence of adverse outcomes of surgical treatment in children with nodular goiter was 27%. Adverse outcomes were observed equally often after organ-preserving operations and after thyroidectomy, but they were of different structure. The frequency of postoperative complications after thyroidectomy performed on the nodular goiter was 27%. Complications presented as postsurgical hypoparathyroidism and vocal cord paresis. In children with nodular goiter, after thyroidectomy hypoparathyroidism occurred more frequently than paresis of the vocal folds. Symptomatic hypocalcemia was observed more frequently than the asymptomatic variant, and in most cases hypoparathyrodism was transient. Among children with a single-node goiter who underwent organ-preserving surgery on the thyroid gland postoperative complications such as hypoparathyroidism and paresis of the vocal folds were not identified. Adverse outcomes (disease recurrence, postoperative hypothyroidism) were observed equally often after hemithyrodectomy and node enucleation. But the risk of recurrence of nodular goiter was significantly more common in children after node enucleation than after hemithyroidectomy and postsurgical hypothyroidism was more common in children with nodular goiter after hemithyrodectomy than after node enucleation. The frequency of adverse outcomes of surgical treatment of Graves’ disease in children was 14%. Complications were presented by post-surgical hypoparathyroidism and vocal cord paresis. All complications occurred only after thyroidectomy. When compared adverse outcomes of thyroidectomy were equally common in both nodular goiter and Graves ‘disease, but persistent dysfunction in the form of permanent hypoparathyroidism and permanent vocal cord paresis were more common in Graves’ disease than in nodular goiter.Conclusion. The results obtained demonstrate the heterogeneity of surgical treatment outcomes structure which depends on the surgical intervention volume. |
| first_indexed | 2024-04-10T01:06:04Z |
| format | Article |
| id | doaj.art-243c71ae1967403faf28519d5a6f3748 |
| institution | Directory Open Access Journal |
| issn | 1682-0363 1819-3684 |
| language | English |
| last_indexed | 2024-04-10T01:06:04Z |
| publishDate | 2017-10-01 |
| publisher | Siberian State Medical University (Tomsk) |
| record_format | Article |
| series | Бюллетень сибирской медицины |
| spelling | doaj.art-243c71ae1967403faf28519d5a6f37482023-03-13T09:58:23ZengSiberian State Medical University (Tomsk)Бюллетень сибирской медицины1682-03631819-36842017-10-0116310711810.20538/1682-0363-2017-3-107-118713Outcomes of surgical treatment of thyroid disease in childrenOlga S. Rogova0Lubov N. Samsonovа1Goar F. Okminyan2Elena V. Kiseleva3Oleg Yu. Latyshev4Elvira P. Kasatkina5Mikhail I. Pykov6Aleksey B. Okulov7Kirill K. Mirakov8Российская медицинская академия непрерывного профессионального образования (РМАНПО)Российская медицинская академия непрерывного профессионального образования (РМАНПО)Российская медицинская академия непрерывного профессионального образования (РМАНПО)Российская медицинская академия непрерывного профессионального образования (РМАНПО)Российская медицинская академия непрерывного профессионального образования (РМАНПО)Российская медицинская академия непрерывного профессионального образования (РМАНПО)Российская медицинская академия непрерывного профессионального образования (РМАНПО)Российская медицинская академия непрерывного профессионального образования (РМАНПО)Детская городская клиническая больница (ДГКБ) им. З.А. Башляевой ДЗМBackground. In recent years there has been a tendency of increase in the proportion of nodular goiter and Graves’ disease in thyroid pathology in children, which necessitates a choice of rational tactics for treatment of these diseases. At present there is no optimal method of treatment for thyroid gland pathology, but one of the methods is surgery. Thyroid surgery due to the determination of the indications and choice of the optimal volume of the surgical intervention continues to be under debate as postoperative complications of surgical treatment of thyroid diseases in children are possible.Aim: to study the outcomes of surgical treatment for thyroid pathology in children, depending on the volume of operation.Materials and methods. This article presents the results of a survey of 77 children operated on in the period of 2002–2016 for Graves’ disease, single-node goiter, and multinodular goiter. The examination included the determination of the levels of ionized calcium and TSH, FT4, FT3 in the blood serum, the evaluation of the functional state of the pituitary-thyroid system, thyroid ultrasound examination, and examination by an otolaryngologist.Results. The incidence of adverse outcomes of surgical treatment in children with nodular goiter was 27%. Adverse outcomes were observed equally often after organ-preserving operations and after thyroidectomy, but they were of different structure. The frequency of postoperative complications after thyroidectomy performed on the nodular goiter was 27%. Complications presented as postsurgical hypoparathyroidism and vocal cord paresis. In children with nodular goiter, after thyroidectomy hypoparathyroidism occurred more frequently than paresis of the vocal folds. Symptomatic hypocalcemia was observed more frequently than the asymptomatic variant, and in most cases hypoparathyrodism was transient. Among children with a single-node goiter who underwent organ-preserving surgery on the thyroid gland postoperative complications such as hypoparathyroidism and paresis of the vocal folds were not identified. Adverse outcomes (disease recurrence, postoperative hypothyroidism) were observed equally often after hemithyrodectomy and node enucleation. But the risk of recurrence of nodular goiter was significantly more common in children after node enucleation than after hemithyroidectomy and postsurgical hypothyroidism was more common in children with nodular goiter after hemithyrodectomy than after node enucleation. The frequency of adverse outcomes of surgical treatment of Graves’ disease in children was 14%. Complications were presented by post-surgical hypoparathyroidism and vocal cord paresis. All complications occurred only after thyroidectomy. When compared adverse outcomes of thyroidectomy were equally common in both nodular goiter and Graves ‘disease, but persistent dysfunction in the form of permanent hypoparathyroidism and permanent vocal cord paresis were more common in Graves’ disease than in nodular goiter.Conclusion. The results obtained demonstrate the heterogeneity of surgical treatment outcomes structure which depends on the surgical intervention volume.https://bulletin.ssmu.ru/jour/article/view/961узловой зоб у детейболезнь грейвса у детейэнуклеация узла щитовидной железыгемитиреоидэктомиясубтотальная тиреоидэктомиятиреоидэктомиягипокальциемияпарез голосовых складокпослеоперационные осложненияпослеоперационный гипотиреозрецидив заболевания |
| spellingShingle | Olga S. Rogova Lubov N. Samsonovа Goar F. Okminyan Elena V. Kiseleva Oleg Yu. Latyshev Elvira P. Kasatkina Mikhail I. Pykov Aleksey B. Okulov Kirill K. Mirakov Outcomes of surgical treatment of thyroid disease in children Бюллетень сибирской медицины узловой зоб у детей болезнь грейвса у детей энуклеация узла щитовидной железы гемитиреоидэктомия субтотальная тиреоидэктомия тиреоидэктомия гипокальциемия парез голосовых складок послеоперационные осложнения послеоперационный гипотиреоз рецидив заболевания |
| title | Outcomes of surgical treatment of thyroid disease in children |
| title_full | Outcomes of surgical treatment of thyroid disease in children |
| title_fullStr | Outcomes of surgical treatment of thyroid disease in children |
| title_full_unstemmed | Outcomes of surgical treatment of thyroid disease in children |
| title_short | Outcomes of surgical treatment of thyroid disease in children |
| title_sort | outcomes of surgical treatment of thyroid disease in children |
| topic | узловой зоб у детей болезнь грейвса у детей энуклеация узла щитовидной железы гемитиреоидэктомия субтотальная тиреоидэктомия тиреоидэктомия гипокальциемия парез голосовых складок послеоперационные осложнения послеоперационный гипотиреоз рецидив заболевания |
| url | https://bulletin.ssmu.ru/jour/article/view/961 |
| work_keys_str_mv | AT olgasrogova outcomesofsurgicaltreatmentofthyroiddiseaseinchildren AT lubovnsamsonova outcomesofsurgicaltreatmentofthyroiddiseaseinchildren AT goarfokminyan outcomesofsurgicaltreatmentofthyroiddiseaseinchildren AT elenavkiseleva outcomesofsurgicaltreatmentofthyroiddiseaseinchildren AT olegyulatyshev outcomesofsurgicaltreatmentofthyroiddiseaseinchildren AT elvirapkasatkina outcomesofsurgicaltreatmentofthyroiddiseaseinchildren AT mikhailipykov outcomesofsurgicaltreatmentofthyroiddiseaseinchildren AT alekseybokulov outcomesofsurgicaltreatmentofthyroiddiseaseinchildren AT kirillkmirakov outcomesofsurgicaltreatmentofthyroiddiseaseinchildren |