Complications of Total Thyroidectomy Performed by Surgical Residents Versus Specialist Surgeons

Overview

Journal Surg Today

Specialty General Surgery

Date 2008 Sep 30

PMID 18820861

Citations 10

Authors

Ali U Emre

Guldeniz Karadeniz Cakmak

Oge Tascilar

Bulent H Ucan

Oktay Irkorucu

Kemal Karakaya

Hakan Balbaloglu

Sami Dibeklioglu

Mesut Gul

Handan Ankarali

Mustafa Comert

Affiliations

Soon will be listed here.

Abstract

Purpose: Surgeon inexperience has been defined as a significant predictor of deleterious outcome in thyroid surgery; however, the safety of training programs in which residents are the primary surgeons is controversial. The objective of this prospective study was to compare the complication rates of total thyroidectomy (TT) performed by residents with those of TT performed by specialist surgeons in similar patient groups.

Methods: Between April 2001 and May 2007, 144 patients underwent TT at our hospital. For 75 operations, the primary surgeon was a resident under the direct supervision of the attending surgeon, and for 69 operations, the primary surgeon was the experienced attending surgeon. Pre-and postoperative vocal cord examinations and serum calcium level evaluations were carried out in all patients.

Results: The rates of temporary (unilateral) recurrent laryngeal nerve (RLN) palsy were 2.66% vs 2.17% after TT performed by the residents vs the attending surgeon, respectively. There were no significant differences in the incidences of temporary hypoparathyroidism (20% vs 20.28%), permanent (unilateral) RLN palsy, hematoma, infection, seroma, and incidental parathyroidectomy between the two groups.

Conclusion: The complication rates of TT performed by residents and attending surgeons were similar. Thus, residents can perform TT safely and effectively under the direct supervision of a senior surgeon. Ultimately, strict adherence to the contemporary principles of thyroid surgery is of paramount importance.

Citing Articles

Results of thyroidectomies according to general surgeons and otolaryngologist and cervico faciale surgeons at the general Hospital of Reference of Niamey, what differences in the protocols of management?.

Saidou A, Djafarou A, Alfari A, Zabeirou Oudou A, Ide K, Bakou O BMC Surg. 2024; 24(1):28.

PMID: 38238721 PMC: 10795351. DOI: 10.1186/s12893-023-02305-y.

Achieving the learning curve in total thyroidectomy: a prospective evaluation on resident's training by CUSUM and KPSS analysis.

Tarallo M, Crocetti D, Gurrado A, Iorio O, Iossa A, Caruso D Ann R Coll Surg Engl. 2022; 104(6):414-420.

PMID: 35175830 PMC: 9157995. DOI: 10.1308/rcsann.2021.0318.

Surgical Complications After Thyroid Surgery: A 10-Year Experience at Jeddah, Saudi Arabia.

Al-Hakami H, Al Garni M, Malas M, Abughanim S, Alsuraihi A, Al Raddadi T Indian J Otolaryngol Head Neck Surg. 2019; 71(Suppl 1):1012-1017.

PMID: 31742111 PMC: 6848463. DOI: 10.1007/s12070-019-01695-x.

Should total thyroidectomies be performed by high-volume endocrine surgeons? A cost-effectiveness analysis.

Anagnostis P, Pliakos I, Panidis S, Chorti A, Stelmach V, Michalopoulos A Endocrine. 2019; 67(1):131-135.

PMID: 31541389 DOI: 10.1007/s12020-019-02087-5.

INCIDENTAL PARATHYROIDECTOMY DURING THYROID SURGERY - RISK, PREVENTION AND CONTROVERSIES; AN EVIDENCE-BASED REVIEW.

Neagoe R, Cvasciuc I, Muresan M, Sala D Acta Endocrinol (Buchar). 2019; 13(4):467-475.

PMID: 31149218 PMC: 6516554. DOI: 10.4183/aeb.2017.467.

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