Introduction: Surgical management plays a crucial role in managing thyroid disease in the pediatric population as evidenced by the increasing volume of such cases over the years. This study aims to evaluate the outcomes of thyroid surgery in children, adolescents, and young adults by meta-analyzing outcomes across several institutions.

Methods: A comprehensive literature search for single institutional studies was performed across PubMed, Science Direct, Embase, Scopus, and Google Scholar. Key variables like mean hospital stay and both transient and permanent complications were recorded. Transient hypocalcemia or hypoparathyroidism was defined as a drop in serum calcium below laboratory reference range postthyroidectomy that resolved within 6 mo. Transient laryngeal nerve injury was characterized by hoarseness or dysphonia arising from neuropraxia or trauma to the nerve that resolved within 6 mos postsurgery. Complications persisting beyond 6 mo were classified as permanent. We performed meta-analysis on complication rates using the metaprop library on R studio.

Results: A total of 2339 studies were retrieved through our search strategy across five databases. Excluding duplicates, the remaining studies were screened resulting in 88 studies being selected for a full text review. Fifty-six studies were excluded due to a lack of outcome specific data leaving a total of thirty-two studies that were included, amounting to 2747 patients with a mean of 86 patients per study. The overall weighted mean age of patients in our study pool was 12.9 ± 4.1 (95% confidence interval [CI]: 12.8-13.1) years. Mean hospital stay was 2.6 ± 1.9 (95% CI: 2.5-2.7) days. Common complications like transient hypocalcemia or hypoparathyroidism was found in 24% (95% CI: 0.2-0.3, I2 = 91%) and transient laryngeal nerve injury was 2% (95% CI: 0.01-0.02, I2 = 35%) of patients. Permanent hypocalcemia or hypoparathyroidism was found in 3% (95% CI: 0.02-0.04, I2 = 65%) patients. Rare complications included permanent laryngeal nerve injury in 1% (95% CI: 0.00-0.01) and hematoma formation in 1% (95% CI: 0.00-0.01).

Conclusions: Pediatric thyroid surgery, although safe, has a high risk of transient hypocalcemia or hypoparathyroidism. Other complications remain under 3%.

Keywords: Complications; Endocrine; Hypocalcemia; Meta-analysis; Pediatric; Thyroidectomy.

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简介： 在儿科人群中，外科管理对甲状腺疾病的治疗起着至关重要的作用，这一点从近年来此类病例数量的增长中可见一斑。本研究旨在通过荟萃分析不同机构的结果来评估儿童、青少年和年轻成人甲状腺手术的结局。

方法： 我们在PubMed、Science Direct、Embase、Scopus 和 Google Scholar 上进行了全面的文献检索，查找单个机构的研究。记录了诸如平均住院天数和暂时性和永久性并发症等关键变量。术后血钙水平低于实验室参考范围且在6个月内恢复的情况被定义为暂时性低钙血症或甲状旁腺功能减退。由神经麻痹或神经损伤引起的声嘶或发音障碍，并且在手术后6个月内恢复的情况被认为是暂时性的喉返神经损伤。持续超过6个月的并发症则归类为永久性。我们使用 R studio 的 metaprop 库对并发症率进行了荟萃分析。

结果： 我们的检索策略从五个数据库中共检索到2339项研究。排除重复后，筛选剩余的研究最终选出88篇进行全文审阅。由于缺乏具体结局数据，56项研究被剔除，最终纳入32项研究，共计2747名患者，每项研究平均有86名患者。我们研究池中患者的加权平均年龄为12.9 ± 4.1（95%置信区间[CI]：12.8-13.1）岁。平均住院天数为2.6 ± 1.9 （95% CI: 2.5-2.7) 天。最常见的并发症是暂时性低钙血症或甲状旁腺功能减退，占患者总数的24%（95% CI：0.2-0.3，I2 = 91%），而暂时性喉返神经损伤则占2% （95% CI: 0.01-0.02, I2 = 35%)。永久性低钙血症或甲状旁腺功能减退的患者占比为3%（95% CI：0.02-0.04，I2 = 65%）。罕见并发症包括永久性喉返神经损伤和血肿形成，各占1%。

结论： 尽管儿童甲状腺手术是安全的，但它有很高的暂时性低钙血症或甲状旁腺功能减退的风险。其他并发症的发生率则低于3%。