Pediatric Increased Risk and Nonlinear Age-Dependent Risk of Hypoparathyroidism After Total Thyroidectomy: A…

Cohort studyWorld journal of surgery· Aug 2026

Pediatric Increased Risk and Nonlinear Age-Dependent Risk of Hypoparathyroidism After Total Thyroidectomy: A 1914-Patient Cohort Study.

Riccardo Maggiore, Lorena Licata, Diego Barbieri … Riccardo Rosati

Endocrine SurgeryCohort studyPrognosisQ1IF 2.0

Pediatric total thyroidectomy carries higher odds of permanent hypoparathyroidism than adult surgery.

Pediatric Increased Risk and Nonlinear Age-Dependent Risk of Hypoparathyroidism After Total Thyroidectomy: A 1914-Patient Cohort Study.

Riccardo Maggiore … Riccardo Rosati

World journal of surgery · Aug 2026 · Q1 in Surgery

Background

Post-thyroidectomy hypoparathyroidism is the most common complication of total thyroidectomy and a key indicator of surgical quality.

Methods

Retrospective cohort study of 1914 consecutive patients undergoing primary total thyroidectomy for Graves' disease or differentiated thyroid carcinoma at a high-volume center, comprising 87 pediatric (< 18 years) and 1827 adult (≥ 18 years) patients operated on by the same endocrine surgical team.

n = 1827 adult

Results

pediatric patients had far higher odds of permanent hypoparathyroidism than adults

OR by subgroup · 95% CI

More results

Transient hypoparathyroidism occurred in 29.9% of pediatric and 17.2% of adult patients (P = 0.004) and permanent hypoparathyroidism in 3.4% and 0.4% (P = 0.011).

Other surgical complications did not differ between groups.

More results

Inadvertent parathyroid excision was uncommon and accounted for only 1 pediatric hypoparathyroidism case, implicating devascularization rather than gland removal.

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Conclusion · 1 of 2

Pediatric patients undergoing primary total thyroidectomy are at increased risk of postoperative hypoparathyroidism independent of surgical indication and extent, even under uniform high-volume surgical conditions, with devascularization the likely mechanism.

Conclusion · 2 of 2

In adults, risk varies non-linearly with age. These findings support age as a determinant of postoperative endocrine outcomes.

Pediatric Increased Risk and Nonlinear Age-Dependent Risk of Hypoparathyroidism After Total Thyroidectomy: A 1914-Patient Cohort Study.

Pediatric Increased Risk and Nonlinear Age-Dependent Risk of Hypoparathyroidism After Total Thyroidectomy: A 1914-Patient Cohort Study.

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