{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:40:34Z","timestamp":1789486834667,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post\u2010thyroidectomy hypoparathyroidism is the most common complication of total thyroidectomy and a key indicator of surgical quality. The influence of age on postoperative risk, across the spectrum from pediatric to adult patients, remains incompletely defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort study of 1914 consecutive patients undergoing primary total thyroidectomy for Graves' disease or differentiated thyroid carcinoma at a high\u2010volume center, comprising 87 pediatric (&lt; 18\u00a0years) and 1827 adult (\u2265 18\u00a0years) patients operated on by the same endocrine surgical team. Transient and permanent hypoparathyroidism were defined according to the 2025 ESES\/AAES\/IAES consensus, with permanent disease confirmed biochemically beyond 12\u00a0months. Multivariable models were adjusted for surgical indication and lymph node dissection; within adults, age was modeled with restricted cubic splines followed by an age\u2010band analysis. Pediatric histopathology was reviewed for inadvertent parathyroid excision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Transient hypoparathyroidism occurred in 29.9% of pediatric and 17.2% of adult patients (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.004) and permanent hypoparathyroidism in 3.4% and 0.4% (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.011). After adjustment, pediatric age remained independently associated with transient (OR 1.86, 95% CI 1.15\u20133.01) and permanent hypoparathyroidism (OR 5.74, 95% CI 1.35\u201320.02). Other surgical complications did not differ between groups. Inadvertent parathyroid excision was uncommon and accounted for only 1 pediatric hypoparathyroidism case, implicating devascularization rather than gland removal. Among adults, age showed a non\u2010linear association with transient hypoparathyroidism, with increased risk at 40\u201350\u00a0years (OR 1.50, 95% CI 1.15\u20131.96;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.003), particularly in differentiated thyroid carcinoma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pediatric patients undergoing primary total thyroidectomy are at increased risk of postoperative hypoparathyroidism independent of surgical indication and extent, even under uniform high\u2010volume surgical conditions, with devascularization the likely mechanism. In adults, risk varies non\u2010linearly with age. These findings support age as a determinant of postoperative endocrine outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70523","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T18:28:41Z","timestamp":1785608921000},"page":"2654-2661","source":"Crossref","is-referenced-by-count":1,"title":["Pediatric Increased Risk and Nonlinear Age\u2010Dependent Risk of Hypoparathyroidism After Total Thyroidectomy: A 1914\u2010Patient Cohort Study"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2869-9859","authenticated-orcid":false,"given":"Riccardo","family":"Maggiore","sequence":"first","affiliation":[{"name":"Department of Surgery Endocrine Surgery Unit IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6613-8489","authenticated-orcid":false,"given":"Lorena","family":"Licata","sequence":"additional","affiliation":[{"name":"Department of Surgery Endocrine Surgery Unit IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Department of Surgery Endocrine Surgery Unit IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Ostinelli","sequence":"additional","affiliation":[{"name":"Department of Surgery Endocrine Surgery Unit IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Vigone","sequence":"additional","affiliation":[{"name":"Department of Pediatrics IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Vincenzi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Pitea","sequence":"additional","affiliation":[{"name":"Department of Pediatrics IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Perticone","sequence":"additional","affiliation":[{"name":"Institute of Endocrine and Metabolic Sciences IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Ciuni","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Surgical Specialties G. Rodolico Hospital  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Giustina","sequence":"additional","affiliation":[{"name":"Institute of Endocrine and Metabolic Sciences IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Rosati","sequence":"additional","affiliation":[{"name":"Department of Surgery Endocrine Surgery Unit IRCCS Ospedale San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0460"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.0104"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2019.02.009"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.20471\/acc.2019.58.01.16"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21195"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1530\/ETJ\u201021\u20100073"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000320028"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21175"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7219"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2227\u2010684X.2014.12.04"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9384"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2017.05.07"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.5402\/2012\/838614"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000001475"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199809000\u201000005"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001688"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010008\u20100366\u20107"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010013\u20102767\u20107"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010020\u201001907\u2010x"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znaf247"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/80.1.27"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1047"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2019.02.033"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013\u20102617"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008\u20100660"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811414511"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2020.02.01"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21119"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40136\u2010013\u20100033\u20106"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70523","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjs.70523","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70523","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:23:36Z","timestamp":1789478616000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.70523"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":30,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/wjs.70523"],"URL":"https:\/\/doi.org\/10.1002\/wjs.70523","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,1]]}}}