A Randomized Prospective Study of Complications Between General Surgery Residents and Attending Surgeons in Near-Total Thyroidectomies
| Autor: | Zeki Acun, Guldeniz Karadeniz Cakmak, Alper Cihan, Suat Can Ulukent, Ali Cesur, Bulent Hamdi Ucan, Mustafa Comert |
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| Přispěvatelé: | Zonguldak Bülent Ecevit Üniversitesi |
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Risk Assessment Postoperative Complications Surgical oncology Medical Staff Hospital medicine Humans Prospective Studies Practice Patterns Physicians' Prospective cohort study Probability Surgical team business.industry Residents Incidence General surgery Incidence (epidemiology) Thyroid Thyroidectomy Internship and Residency General Medicine Middle Aged medicine.disease Thyroid Diseases Thyroid surgery Surgery Treatment Outcome medicine.anatomical_structure Hypoparathyroidism Female Clinical Competence business Complication Follow-Up Studies |
| Zdroj: | Surgery Today. 34:997-1001 |
| ISSN: | 1436-2813 0941-1291 |
| DOI: | 10.1007/s00595-004-2857-7 |
| Popis: | Purpose. Recurrent laryngeal nerve palsy and hypoparathyroidism are the most common and serious complications after thyroid operations. Surgeon experience has been defined as a significant factor in the number of complications occurring in thyroid surgery. There has so far been no prospective randomized study that compares the complication rates between residents and the attending surgeon in statistically similar patient groups in which all of the patients undergo the same type of thyroid surgery by the same surgical team. In this prospective study the performances of residents and attending surgeons were evaluated and compared according to the complication rates in near-total thyroidectomies. Methods. One hundred and fifty-two patients underwent near-total thyroidectomies between April 2001 and May 2003. The number of randomly selected patients operated on by residents at the level of postgraduate year two, under the direct supervision of an attending surgeon, and the number of patients operated on by attending surgeons were 78 and 74, respectively. All patients had preoperative and postoperative videolaryngostroboscopic examinations of the vocal cords and serum calcium level evaluation. Results. The rates of temporary vocal cord paralysis with respect to the nerves at risk for residents and attending surgeons were 3.7% and 2.7%, respectively. The temporary hypoparathyroidism rate was 8.1% for attending surgeons, whereas it was found to be 6.4% for residents. Neither any cases of permanent vocal cord paralysis nor permanent hypoparathyroidism were detected. Conclusion. Our results indicate that the complication rates in near-total thyroidectomies performed by residents and attending surgeons are similar. Thyroid surgery can therefore be safely and effectively performed by residents under close supervision. |
| Databáze: | OpenAIRE |
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