Thyroidectomy for Graves' disease in children: Indications and complications.
BACKGROUND
The utilization of thyroidectomy for Graves' disease remains controversial; we aim to evaluate the indications for and complications of thyroidectomy for Graves' in children.


METHODS
A retrospective analysis was performed on all Graves' patients who underwent thyroidectomy from 2009 to 2013 at a high volume academic center. Pediatric patients were <18years old, and a comparative analysis of indications for surgery and complications was performed.


RESULTS
167 patients underwent thyroidectomy: 31 pediatric patients and 136 adults. Failure of antithyroid medications was the indication for surgery in 55% of the children vs 36% of adults (p=0.05). Mean duration of medications prior to surgery was similar. No children had failed RAI therapy prior to surgery, but 12.5% of the adult population had (p=0.04). Surgical outcomes were similar.


CONCLUSIONS
Clinicians may be more likely to refer children who fail medical treatment to surgery over RAI. Thyroidectomy at a high volume hospital should be discussed as a treatment option for children with Graves'.
University of Wisconsin, Department of Surgery, Section of Endocrine Surgery, 600 Highland Ave, K4/739, Madison, WI 53792. Electronic address: delfenbe@uci.edu.
Dawn M
DM
Elfenbein
University of Wisconsin, Department of Surgery, Section of Endocrine Surgery, 600 Highland Ave, K4/739, Madison, WI 53792.
Micah
M
Katz
University of Wisconsin, Department of Surgery, Section of Endocrine Surgery, 600 Highland Ave, K4/739, Madison, WI 53792.
David F
DF
Schneider
University of Wisconsin, Department of Surgery, Section of Endocrine Surgery, 600 Highland Ave, K4/739, Madison, WI 53792.
Herbert
H
Chen
University of Wisconsin, Department of Surgery, Section of Endocrine Surgery, 600 Highland Ave, K4/739, Madison, WI 53792.
Rebecca S
RS
Sippel
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006111:Graves Disease / Q000601:surgery*; D061847:Hospitals, High-Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D013965:Thyroidectomy; D016896:Treatment Outcome; D055815:Young Adult
Pediatric Graves' disease; Pediatric hyperthyroidism; Shared decision making; Thyroidectomy