PURPOSE: Resident participation in operative procedures is mandatory in educational residency programs but remains controversial, especially in the context of patient safety. This study compared the surgical quality and outcomes of thyroidectomies performed by surgical residents (RESs) and board-certified surgeons (BCSs). METHODS: This retrospective matched-pair study included patients undergoing thyroidectomies for multinodular goiter, Grave's disease and early-stage thyroid cancer that were performed by a RES with BCS supervision between 2006 and 2014. The intraoperative and postoperative course, complication rates and handling of the recurrent laryngeal nerve (RLN) and parathyroid glands were analyzed. RESULTS: In total, 112 thyroidectomies that were performed by a RES fulfilled the inclusion criteria and were matched 1:1 with BCS patients. We included 88 hemithyroidectomies, 80 subtotal thyroidectomies and 56 total thyroidectomies. No significant differences in the handling of the RLN or parathyroid glands, the rates of postoperative RLN palsies or the rates of hypocalcaemia were found. No intraoperative complications led to the replacement of the RES as the surgeon-in-charge. Three RES and two BCS patients experienced postoperative haemorrhages (p = 0.205), and three surgical site infections (p = 1.000) occurred in each group. The mean operative time and the length of stay did not differ significantly between the two groups. CONCLUSIONS: Major aspects of patient safety in thyroid surgery are not affected by resident participation. Thyroidectomies performed by RES are not significantly longer and reveal no differences in length of stay or complication rates. The economic burden of resident involvement is modest.
PURPOSE: Resident participation in operative procedures is mandatory in educational residency programs but remains controversial, especially in the context of patient safety. This study compared the surgical quality and outcomes of thyroidectomies performed by surgical residents (RESs) and board-certified surgeons (BCSs). METHODS: This retrospective matched-pair study included patients undergoing thyroidectomies for multinodular goiter, Grave's disease and early-stage thyroid cancer that were performed by a RES with BCS supervision between 2006 and 2014. The intraoperative and postoperative course, complication rates and handling of the recurrent laryngeal nerve (RLN) and parathyroid glands were analyzed. RESULTS: In total, 112 thyroidectomies that were performed by a RES fulfilled the inclusion criteria and were matched 1:1 with BCS patients. We included 88 hemithyroidectomies, 80 subtotal thyroidectomies and 56 total thyroidectomies. No significant differences in the handling of the RLN or parathyroid glands, the rates of postoperative RLN palsies or the rates of hypocalcaemia were found. No intraoperative complications led to the replacement of the RES as the surgeon-in-charge. Three RES and two BCS patients experienced postoperative haemorrhages (p = 0.205), and three surgical site infections (p = 1.000) occurred in each group. The mean operative time and the length of stay did not differ significantly between the two groups. CONCLUSIONS: Major aspects of patient safety in thyroid surgery are not affected by resident participation. Thyroidectomies performed by RES are not significantly longer and reveal no differences in length of stay or complication rates. The economic burden of resident involvement is modest.
Authors: Benjamin Zendejas; David A Cook; Juliane Bingener; Marianne Huebner; William F Dunn; Michael G Sarr; David R Farley Journal: Ann Surg Date: 2011-09 Impact factor: 12.969
Authors: Martin de Santibañes; Fernando A Alvarez; Esteban Sieling; Hernan Vaccarezza; Eduardo de Santibañes; Carlos A Vaccaro Journal: Langenbecks Arch Surg Date: 2014-12-10 Impact factor: 3.445
Authors: Roberto Hernández-Irizarry; Benjamin Zendejas; Shahzad M Ali; Christine M Lohse; David R Farley Journal: J Surg Educ Date: 2012 Nov-Dec Impact factor: 2.891
Authors: Daniel M Relles; Richard A Burkhart; Michael J Pucci; Jocelyn Sendecki; Renee Tholey; Ross Drueding; Patricia K Sauter; Eugene P Kennedy; Jordan M Winter; Harish Lavu; Charles J Yeo Journal: J Gastrointest Surg Date: 2013-11-13 Impact factor: 3.452
Authors: Kevin R Kasten; Adam C Celio; Lauren Trakimas; Mark L Manwaring; Konstantinos Spaniolas Journal: Surg Endosc Date: 2017-07-19 Impact factor: 4.584