Highlights
- •21% of surgeon members surveyed from the American Pediatric Surgical Association reported performing 1 or more pediatric thyroid surgeries in the past year.
- •The majority of surgeons who perform pediatric thyroid surgery report doing so with a colleague.
Abstract
Introduction
The topics of sub-specialization and regionalization of care have garnered increased
attention among pediatric surgeons. Thyroid surgeries are one such sub-specialty and
are commonly concentrated within practices. A national survey was conducted examining
current surgeon practices and beliefs surrounding pediatric thyroid surgery.
Methods
Non-resident members of the American Pediatric Surgical Association (APSA) were surveyed
in October 2020. Respondents were stratified based on self-reported thyroid surgical
experience. Those who performed thyroid surgery were asked about surgical technique
and operative practices; those who did not were asked about referral patterns. All
respondents were asked about perceptions surrounding the volume-outcome relationship
for pediatric thyroid surgery.
Results
Among 1015 APSA members, 405 (40%) responded, with 79% (317/400) practicing at academic
hospitals, 58% (232/401) practicing in major metropolitan area, and 41% (161/392)
with over 10 years of attending pediatric surgery experience. Most respondents (88%,
n = 356) agreed that thyroid surgery volume affects outcome, though wide variation
was reported in the annual case threshold for “high volume” surgery. Eighty-four respondents
(21%) reported performing ≥ 1 pediatric thyroid surgery in the past year. Of these,
82% routinely use recurrent laryngeal nerve monitoring, 32% routinely send hemithyroidectomy
patients home the same day, and there was little consensus surrounding postoperative
hypocalcemia management. The majority of respondents endorse performing thyroid procedures
with a colleague.
Conclusions
Pediatric thyroid surgery appears to be performed by a subset of active pediatric
surgeons, most of whom endorse the use of a dual operating team. More evidence is
needed to build consensus around additional perioperative practices.
Keywords
List of abbreviations:
APSA (American Pediatric Surgical Association), PTH (parathyroid hormone), RLN (recurrent laryngeal nerve)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 15, 2022
Accepted:
January 8,
2022
Received in revised form:
December 27,
2021
Received:
September 3,
2021
Footnotes
✰Level of Evidence: Treatment Study, Level IV
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
