4.0 Article

Thyroidectomy: is it safe to be performed by general surgery residents? - single centre experience

Journal

ACTA CHIRURGICA BELGICA
Volume 123, Issue 3, Pages 266-271

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/00015458.2021.1979185

Keywords

Thyroidectomy; surgeon training; postoperative complications; resident education

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The aim of this study was to assess the safety of thyroidectomy performed by general surgery residents. The results showed that thyroidectomy performed by residents under the supervision of experienced general surgery specialists can be as safe as those performed by specialists.
Background Thyroidectomy carries a risk of two crucial complications - recurrent nerve palsy and hypocalcaemia. The aim of the study was to assess the safety of thyroidectomy performed by general surgery residents. Methods Data of 515 patients, who underwent total thyroidectomy between the years 2015 and 2019, were prospectively collected. Inclusion criteria were as follows: age >18 years old, patients who underwent total thyroidectomy, no change of operator during the surgery. The study group was divided into two groups: operated by general surgery specialists (385 patients-group 1) and operated by residents with the supervision of experienced general surgery specialists as assistants (130 patients-group 2). Results Demographic factors did not differ statistically between groups. Median operative time was 65 min (55-85 IQR) and 90 min (75-110 IQR) in groups 1 and 2, respectively (p < 0.001). Complications occurred in 97 (18.7%) patients in group 1 and 25 (19.3%) patients in group 2 (p = 0.893). Recurrent nerve palsy diagnosed with laryngoscopy was the most common complication - 10.2% and 9.2% of patients, respectively (p = 0.754). Permanent vocal paresis occurred in 2.3% and 3.2%, respectively (p = 0.786). Postoperative symptomatic hypocalcaemia occurred in 7% of patients in group 1 and 10% of patients in group 2 (p = 0.271). Logistic regression did not show that resident as the operator with or without intraoperative neuromonitoring is a risk factor for any complications. Conclusion The results of the present study show that thyroidectomy performed by a general surgery resident under supervision can be as safe as the one performed by a specialist.

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