Pediatric endocrine surgery: Who is operating on our children?

Tuggle, Charles T.; Roman, Sanziana A.; Wang, Tracy; Boudourakis, Leon; Thomas, Daniel C.; Udelsman, Robert; Sosa, Julie Ann

doi:10.1016/j.surg.2008.08.033

Cited by 175 publications

(132 citation statements)

References 19 publications

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“…Treatment and prognosis for these varied lesions should ideally be stratified to represent the risks of persistent/recurrent disease, and that will require an additional risk-stratification scheme beyond TNM classification. Studies have confirmed the notion that children with DTC have lower rates of complications when surgery is performed by experienced thyroid surgeons (70)(71)(72). For this reason, the current task force recommends that children with DTC should be operated upon by experienced thyroid surgeons.…”

Section: In Children With Dtcmentioning

confidence: 86%

“…The lower incidence of thyroid disease requiring surgical intervention in children combined with a higher incidence of locoregional lymph node metastasis has been associated with an increased risk of complications for pediatric patients undergoing TT. Utilizing high-volume thyroid surgeons, defined as a surgeon who performs 30 or more cervical endocrine procedures annually, can reduce the rate of complications (70,71). In a cross-sectional analysis of over 600 pediatric patients undergoing thyroid surgery, there were fewer general complications (8.7% vs. 13.4%) and endocrine complications (5.6% vs. 11%) when the procedures were performed by high-volume surgeons (71).…”

Section: Recommendation Rating: a And Recommendation 12(d)mentioning

confidence: 99%

“…Utilizing high-volume thyroid surgeons, defined as a surgeon who performs 30 or more cervical endocrine procedures annually, can reduce the rate of complications (70,71). In a cross-sectional analysis of over 600 pediatric patients undergoing thyroid surgery, there were fewer general complications (8.7% vs. 13.4%) and endocrine complications (5.6% vs. 11%) when the procedures were performed by high-volume surgeons (71). In addition, the duration of stay and cost were significantly lower when the procedure was performed by a high-volume surgeon (71).…”

Section: Recommendation Rating: a And Recommendation 12(d)mentioning

confidence: 99%

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Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

Francis

Waguespack

Bauer

et al. 2015

Thyroid

929

1,365

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Background: Previous guidelines for the management of thyroid nodules and cancers were geared toward adults. Compared with thyroid neoplasms in adults, however, those in the pediatric population exhibit differences in pathophysiology, clinical presentation, and long-term outcomes. Furthermore, therapy that may be recommended for an adult may not be appropriate for a child who is at low risk for death but at higher risk for long-term harm from overly aggressive treatment. For these reasons, unique guidelines for children and adolescents with thyroid tumors are needed. Methods: A task force commissioned by the American Thyroid Association (ATA) developed a series of clinically relevant questions pertaining to the management of children with thyroid nodules and differentiated thyroid cancer (DTC). Using an extensive literature search, primarily focused on studies that included subjects £ 18 years of age, the task force identified and reviewed relevant articles through April 2014. Recommendations were made based upon scientific evidence and expert opinion and were graded using a modified schema from the United States Preventive Services Task Force. Results: These inaugural guidelines provide recommendations for the evaluation and management of thyroid nodules in children and adolescents, including the role and interpretation of ultrasound, fine-needle aspiration cytology, and the management of benign nodules. Recommendations for the evaluation, treatment, and follow-up of children and adolescents with DTC are outlined and include preoperative staging, surgical management, postoperative staging, the role of radioactive iodine therapy, and goals for thyrotropin suppression. Management algorithms are proposed and separate recommendations for papillary and follicular thyroid cancers are provided.

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Section: In Children With Dtcmentioning

confidence: 86%

Section: Recommendation Rating: a And Recommendation 12(d)mentioning

confidence: 99%

Section: Recommendation Rating: a And Recommendation 12(d)mentioning

confidence: 99%

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Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

Francis

Waguespack

Bauer

et al. 2015

Thyroid

929

1,365

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“…U najmłodszych dzieci wzrasta również ryzyko uszkodzenia nerwów krtaniowych wstecznych. W wielu opracowaniach podkreśla się związek bezpieczeństwa zabiegu z doświadczeniem chirurga wykonują-cego tyreoidektomię [19][20][21][22]. Operacje tego typu powinny być wykonywane w ośrodkach referencyjnych.…”

Section: Dyskusjaunclassified

“…2017.16.1.58. [19][20][21][22][23][24] Rak rdzeniasty tarczycy -badania i obserwacje dzieci z rodzin ryzyka…”

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Untitled

Mołdoch-Łukasik¹,

Grajewska-Ferens²,

Pyrżak³

2017

Pediatr. Endocrinol.

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Słowa kluczowe rak rdzeniasty tarczycy, protoonkogen RET, profilaktyczna tyreoidektomia StreszczenieRak rdzeniasty tarczycy jest to rzadko występujący nowotwór wywodzący się z komórek okołopęche-rzykowych C. W około 25% przypadków występuje rodzinnie jako składowa zespołu mnogiej gruczolakowatości wewnątrzwydzielniczej typu 2 (MEN 2). Rodzinne postacie nowotworu są związane z aktywującą mutacją protoonkogenu RET w linii komórek germinalnych. Dziedziczenie jest autosomalne dominujące, ryzyko wystąpienia nowotworu u krewnych pierwszego stopnia wynosi 50%. W artykule przedstawiono badania dzieci z rodzin obciążonych dziedziczną postacią choroby. U większości badaniem molekularnym potwierdzono obecność specyficznej mutacji w genie RET. Właściwym postępowaniem w przypadku tych pacjentów jest profilaktyczna tyreoidektomia przed wystąpieniem nowotworu. Key words medullary thyroid carcinoma, RET proto-oncogene, prophylactic thyroidectomy AbstractMedullary thyroid carcinoma is a rare malignant neoplasm arising from the parafollicular thyroid cells. About 25 percent of cases are familial as part of the multiple endocrine neoplasia type 2 (MEN2) syndrome. Hereditary form of the disease is connected with activating germline RET proto-oncogene mutations. These mutations are inherited in an autosomal dominant pattern, the risk of MTC in a first-degree relative is 50 percent. In this article we describe children from families with hereditary form of MTC. Most of children have a specific RET proto-oncogene mutation confirmed by genetic testing. Prophylactic thyroidectomy before MTC develops is recommended for these patients.

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