Risk factors associated with postoperative complications in pediatric thyroidectomy: A single-center Vietnamese experience

Abstract

Background

Pediatric thyroid carcinoma presents unique surgical challenges, with potentially significant postoperative complications affecting long-term developmental outcomes. This investigation aimed to evaluate postoperative complications following thyroidectomy in pediatric patients and identify associated prognostic factors within a high-volume Vietnamese surgical center.

Methods

A retrospective analysis was conducted on 112 pediatric patients (≤18 years) who underwent thyroidectomy for differentiated thyroid carcinoma between January 2014 and January 2023. Primary outcomes included the incidence and characteristics of postoperative complications, particularly focusing on recurrent laryngeal nerve injury and hypoparathyroidism. Risk factors were evaluated using univariate and multivariate analyses.

Results

The cohort predominantly comprised female patients (68.8 %), with a mean age of 15.2 ± 2.7 years. Papillary thyroid carcinoma constituted 96.4 % of cases. Total thyroidectomy was performed in 70.5 % of patients, with central compartment lymph node dissection in 83.0 %. Transient recurrent laryngeal nerve dysfunction occurred in 16.1 % of cases, while transient hypocalcemia affected 24.1 % of patients. No permanent complications were observed. Multivariate analysis identified total thyroidectomy as an independent predictor of both complications (p < 0.05). Central compartment nodal metastatic burden (>5 nodes) significantly correlated with transient recurrent laryngeal nerve dysfunction (p < 0.05).

Conclusions

Low complication rates espicially the absence of permanent complications support the safety of thyroidectomy in pediatric single-center in Vietnam. The study underscores the importance of expertise in managing pediatric thyroid carcinoma, while identifying specific risk factors that may inform surgical decision-making and patient counseling.