| アブストラクト | BACKGROUND: Little is known about perioperative outcomes after pediatric thyroidectomy. This study was performed to compare perioperative outcomes between children and adults undergoing thyroid cancer surgery using a nationwide inpatient database in Japan. METHODS: Using the Japanese Diagnosis Procedure Combination database, we identified patients aged 0 to 40 years with thyroid cancer who underwent thyroidectomy from July 2010 to March 2020. To compare the occurrence of in-hospital morbidities including local complications (e.g., recurrent laryngeal nerve paralysis, postoperative bleeding), duration of anesthesia, postoperative length of stay, and total hospitalization costs between children (0-18 years) and adults (19-40 years), we used multivariable logistic regression analysis for the occurrence of in-hospital morbidities and linear regression for other outcomes. RESULTS: For 16,016 eligible patients (666 children vs. 15,350 adults), no significant differences between the two groups were found in any in-hospital morbidity (5.4% vs. 5.9%; adjusted odds ratio [OR], 0.80; 95% confidence interval [CI], 0.57-1.14; P = 0.23), local complications (5.0% vs. 5.5%; OR, 0.80; 95% CI, 0.55-1.15; P = 0.22), recurrent laryngeal nerve paralysis (2.1% vs. 2.4%; OR, 0.78; 95% CI, 0.45-1.35; P = 0.37), or postoperative bleeding (1.7% vs. 1.4%; OR, 0.99; 95% CI, 0.53-1.87; P = 0.98). Children showed a longer duration of anesthesia (difference, 20 minutes; 95% CI, 13-27; P < 0.001) and higher total costs (difference, 445 US dollars; 95% CI, 239-651; P < 0.001) than adults. CONCLUSION: This large nationwide cohort study showed no significant difference in perioperative complications between children and adults undergoing thyroid cancer surgery. |
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| ジャーナル名 | Annals of clinical epidemiology |
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| 投稿日 | 2022/9/29 |
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| 投稿者 | Fujiogi, Michimasa; Konishi, Takaaki; Michihata, Nobuaki; Hashimoto, Yohei; Matsu, Hiroki; Ishimaru, Tetsuya; Fushimi, Kiyohide; Yasunaga, Hideo; Fujishiro, Jun |
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| 組織名 | Department of Pediatric Surgery, Graduate School of Medicine, The University of;Tokyo.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo.;Department of Breast and Endocrine Surgery, Graduate School of Medicine, The;University of Tokyo.;Department of Health Services Research, Graduate School of Medicine, The;Department of Ophthalmology, Graduate School of Medicine, The University of;Department of Pediatric Surgery, Saitama Children's Medical Center.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38505377/ |
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