Importance of Surgeon Experience in the Surgical Management of Thyroid Cancer
Before the nineteenth century, thyroidectomy was associated with significant mortality. However, with improved surgical technique and experience in the late nineteenth and early twentieth centuries, it became increasingly safe; in the contemporary era, thyroidectomy is a common surgical procedure for both benign and malignant conditions, with near-zero mortality rates. However, significant morbidity can occur from thyroidectomy-specific complications, such as injury to the recurrent laryngeal nerve and/or hypoparathyroidism. The incidence of these complications has been shown to be higher when surgery is performed for malignancy and/or by low-volume surgeons. This correlation between volume and outcomes has been well documented across multiple surgical subspecialties and a variety of procedures, including thyroidectomy. The improved outcomes observed when thyroidectomy is performed by a high-volume surgeon include not only decreased rates of complications but also improved oncologic resections with a resulting decreased risk for recurrence and reoperation.
KeywordsThyroid cancer Thyroidectomy Surgeon volume Patient outcome High-volume surgeons
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