Clinical Characteristics and Surgical Outcomes of Paediatric Thyroid Disorders in a Nigerian Mission Hospital: A Nine-Year Review.

Abstract

Background: Paediatric goitre requiring surgery is uncommon and presents a unique clinical challenge. Data on its presentation and surgical outcomes in Nigeria are limited. This study reviews the clinical presentation, operative treatment, and outcomes of children and adolescents who underwent thyroid surgery at a mission hospital in Southern Nigeria. Methodology: This was a retrospective descriptive case series of children and adolescents aged 0-17 years who underwent surgery for thyroid disorders at a mission hospital in Abia State, Nigeria, between January 2015 and December 2023. Data were extracted from clinical records, operative notes, and histopathology reports. Variables included demographic characteristics, clinical presentation, thyroid function status, surgical procedure, histopathological diagnosis, and postoperative complications. Data were analysed using descriptive statistics. Fisher's exact test was used to compare postoperative complication rates between types of thyroidectomy. Results: Of 1,071 thyroidectomies performed during the study period, 43 paediatric cases met the inclusion criteria and were analysed. The median age was 16 years, with an interquartile range of 14-17 years, and 36 patients were female. Total thyroidectomy was performed in 34 patients, while nine underwent lobectomy. Histopathological diagnoses were benign in 39 patients and malignant in four. Diffuse thyroid follicular hyperplasia in Graves' disease was the most common clinicopathological diagnosis, followed by multinodular goitre. Postoperative complications were recorded in seven patients, with transient hypocalcaemia and neck haematoma being the most frequent. There was no apparent relationship between the type of surgery and postoperative complications. Conclusion: Paediatric goitre requiring surgery was uncommon and occurred mainly in female adolescents. Most lesions were benign, while malignancies were infrequent but clinically important. Short-term surgical outcomes were generally favourable, supporting the feasibility of paediatric thyroid surgery in a high-volume hospital setting.