Thyroid Surgery: A Comparison of Outcomes between Experts and Surgeons in Training

Abstract

OBJECTIVES: Our objective was to compare the results of thyroid surgery performed by residents in a large metropolitan public hospital (MPH) with those performed by faculty in a large private hospital (PH) setting. METHODS: All records of thyroid surgery performed by otolaryngologists for the period between 1986 and 1998 were reviewed. Inclusion criteria were adequacy of data and follow-up. Ninety-two thyroid procedures performed by residents in an MPH were compared with 181 thyroid operations in a PH setting performed by the faculty of these residents for differences in accuracy of diagnostic studies, operative parameters, and complication rates. RESULTS: The demographic distribution in both groups was similar. Presenting symptoms were twice as frequent in the MPH group (45% vs 22%). More total thyroidectomies were performed in the PH group (49% vs 32%). Blood loss, operative time, and hospitalization days were similar in both groups. Preoperative fine needle aspiration and intraoperative frozen section results showed sensitivities and specificities that were comparable. No permanent vocal cord paralysis was observed in either group. Permanent hypocalcemia was more frequent in the PH group (8.8%:PH vs 5.1%:MPH). CONCLUSIONS: The results of thyroid surgery performed by residents in training in an Otolaryngology-Head & Neck Surgery program in an MPH, measured by rates of complications, length of hospitalization, and duration of surgery, are similar to those of faculty at a PH setting in groups of patients with very similar characteristics.