Patients who undergo thyroid removal may be less likely to suffer complications if their surgeon performs many such surgeries each year, a new study says.
Removal of the thyroid gland, located at the base of the neck, is a common operation. More than 72,300 total thyroidectomies are performed in the United States annually, usually to treat thyroid cancer or benign thyroid diseases, the study authors said.
The authors examined data from nearly 17,000 American adults who had their thyroid removed between 1998 and 2009. About half these patients had cancer, and the other half had thyroid disease.
Overall, 6 percent of the patients had complications after their surgery, such as damage to voice box nerves, excessive bleeding, poor wound healing, breathing or heart problems, hormone deficiency and death.
Complication rates were 4 percent among patients whose surgeon performed 25 or more total thyroidectomies a year (high-volume surgeons) and 6 percent among patients whose surgeon did fewer than 25 such surgeries a year.
Only 19 percent of the patients in the study were operated on by high-volume surgeons. The median number of total thyroidectomies performed by surgeons was seven, according to the study.
The researchers calculated that patients undergoing the operation by a surgeon who performed only one thyroidectomy per year had a 65 percent increased risk of complications, compared to patients of high-volume surgeons. More than half the surgeons in the study performed just one thyroidectomy per year.
While the researchers only found an association between a doctor’s surgery rates and thyroidectomy complications, they reported that, on average, patients with low-volume surgeons had twice as long a hospital stay — two days versus one day. They also had higher hospital costs — $6,375 vs. $5,863.
“Although the surgeon’s experience is one of the most predictive factors for patient outcomes from total thyroidectomy, the number of cases that defines a high-volume thyroid surgeon was unclear,” said senior investigator Dr. Julie Ann Sosa, chief of endocrine surgery at Duke University Medical Center in Durham, N.C.
Before selecting a thyroid surgeon, patients should ask surgeons how many such surgeries they perform each year, Sosa said in a college news release.
The study was scheduled for presentation Wednesday at the annual meeting of the American College of Surgeons in Chicago. Data and conclusions presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.
The U.S. National Library of Medicine has more about thyroid removal.