Patient Safety in Surgery for Thyroid Cancer

Abstract

This chapter describes the problem of human errors during surgical treatment of patients with thyroid cancer.

Commentary

• Andrzej L. Komorowski 

1. Department of General Surgery, Hospital Virgen del Camino, Sanlúcar de Barrameda, Spain

   Andrzej L. Komorowski

Patient safety is clearly the cornerstone of every surgical procedure. The vast numbers of serious surgical adverse events are caused by simple, human errors, which can result in disastrous consequences. Yet, the risk of serious, even unthinkable, events can be lessened by some relatively simple actions, e.g. by repeatedly going over the checklists before every single procedure. This practice should be mandatory.

A key point made by the author is the problem of communication between team members. The ideal scenario would be for all team members to get along well, with the single aim of ensuring patient safety and welfare. Unfortunately, in the real world, surgeons have little say, if any, when it comes to staffing. It is also not uncommon to find that persons responsible for hospital staffing do not understand the specificity of the surgical entourage. To overcome these problems, surgeons would do well to follow Dr Vats’ advice by using surgical checklists, time-outs and team debriefings, which would help teams to coordinate and minimize the risks of human error.

Finally, it is my personal opinion that prophylactic antibiotics are of little use in thyroid surgery. However, should antibiotic prophylaxis be initiated, it should be underlined that treatment should start 60 min before anaesthesia and not continued after the operation.