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Practice Patterns and Outcomes of Pediatric Thyroid Surgery: An NSQIP Analysis.
- Source :
-
The Journal of surgical research [J Surg Res] 2020 Nov; Vol. 255, pp. 181-187. Date of Electronic Publication: 2020 Jun 18. - Publication Year :
- 2020
-
Abstract
- Background: Pediatric thyroid cancer rates are rising. The aim of this study was to determine the state of current practice and outcomes for pediatric thyroidectomies using the pediatric National Surgical Quality Improvement Program (NSQIP-P) with specific attention to differences based on surgeon type/specialty.<br />Methods: All cases of pediatric thyroidectomies and neck dissections within the NSQIP-P database were identified from 2015 to 2017. Patient, disease, and treatment-related factors affecting 30-day outcomes were analyzed using univariate and multivariate analyses.<br />Results: A total of 1300 cases were identified. Mean age at time of surgery was 14.0 (SD 3.5) years. The majority of patients were female (78%) and Caucasian (72%). Pediatric general surgeons performed the largest proportion of cases (42%) followed by pediatric otolaryngologists (33%). Malignancies were present in 29% of cases. The overall rate of complications was 3.0%. On multivariate analysis, non-pediatric surgeons were more likely to operate on Caucasian children, malignant pathology, and perform modified radical neck dissections. Pediatric surgeons were more likely to have longer operative times, have specialized in otolaryngology, and operate on sicker children (ASA>2). There were no differences in length of stay or overall complications rates.<br />Conclusions: This study shows that pediatric surgeons currently perform the majority of thyroid surgeries in children. While unable to assess surgeon volume, our data show that thyroid surgery is being safely performed at NSQIP-affiliated hospitals by both non-pediatric and pediatric surgeons. Further studies are needed to determine if there are differences in specific procedure-related complications and long-term outcomes between surgeon types.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Child
Female
Humans
Male
Otolaryngology statistics & numerical data
Pediatricians statistics & numerical data
Postoperative Complications epidemiology
Quality Improvement
Retrospective Studies
Surgeons statistics & numerical data
United States epidemiology
Neck Dissection statistics & numerical data
Thyroidectomy statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1095-8673
- Volume :
- 255
- Database :
- MEDLINE
- Journal :
- The Journal of surgical research
- Publication Type :
- Academic Journal
- Accession number :
- 32563758
- Full Text :
- https://doi.org/10.1016/j.jss.2020.05.056