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Who Should Do Thyroid Surgery?

  • Tracy S. WangEmail author
  • Julie Ann Sosa

Abstract

Thyroidectomy is typically associated with low rates of morbidity and mortality, although thyroidectomy-specific complications of recurrent laryngeal nerve injury and hypoparathyroidism have significant consequences for patient quality of life, underscoring the importance of optimizing circumstances for successful patient outcomes. Numerous population-based studies have demonstrated the association between increased surgeon volume and enhanced patient outcomes among patients undergoing thyroidectomy. On average, high-volume surgeons consistently have been shown to have lower (general and endocrine-specific) complication rates, shorter hospital length of stay, and decreased costs; this association is particularly evident for vulnerable populations, such as children, elderly, and racial minorities. The number of procedures considered to be “high-volume” for thyroid surgery is unclear, as the volume thresholds utilized in published studies have been variable, ranging from >30 to >100 procedures per year. Despite increasing referrals to high-volume surgeons, the majority of thyroidectomies are still performed by lower-volume surgeons, in part secondary to geographic and socioeconomic barriers in patient access to high-volume, experienced thyroid surgeons. The challenge will be for educators to think together with policy makers and payers to assure that there is adequate and distributed supply to meet that demand. Going forward, practice guidelines well might include data related to provider volume when formulating best practice recommendations in the arena of thyroid disease.

Keywords

Thyroidectomy Surgeon volume Patient outcomes High-volume surgeons 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of SurgeryMedical College of WisconsinMilwaukeeUSA
  2. 2.Endocrine Neoplasia Diseases Group, Duke Cancer InstituteDuke UniversityDurhamUSA
  3. 3.Department of SurgeryDuke UniversityDurhamUSA

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