Education in thyroid surgery: a matched-pair analysis comparing residents and board-certified surgeons

Reinisch, Alexander; Malkomes, Patrizia; Liese, Juliane; Schreckenbach, Teresa; Holzer, Katharina; Bechstein, Wolf O.; Habbe, Nils

doi:10.1007/s00423-016-1390-7

Cited by 9 publications

(14 citation statements)

References 18 publications

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“…This is in line with a recent study that identified no differences in short‐term morbidity and mortality in patients who underwent major head and neck surgery with or without resident participation . Although the current NSQIP dataset limits the ability for evaluation of recurrent laryngeal nerve dysfunction or hypoparathyroidism, other smaller studies did not find any significant differences in risk of these complications between patients operated upon by attending surgeons alone, or with resident participation …”

Section: Discussionsupporting

confidence: 89%

“…Our analysis of a large dataset agrees with similar observations in pediatric otolaryngology, urology, orthopedics, general surgery, and others, in which prolongation of operative time was directly associated with a teaching environment . A smaller analysis of hemithyroidectomy procedures by Reinisch et al evaluated data from 88 patients and found that although resident‐assisted procedures took 10 minutes longer to complete than those performed by attending surgeons alone, this difference did not achieve statistical significance in the small patient cohort. Pollei et al identified increased cost and operative time related to the institution of otolaryngology resident training.…”

Section: Discussionsupporting

confidence: 87%

“…The quality of operative care and surgical outcomes rendered by resident trainees has been scrutinized in a variety of clinical settings, including general surgery, gynecology, urology, neurosurgery, and otorhinolaryngology . Resident participation has been associated with increasing operative time in a variety of surgical populations.…”

Section: Discussionmentioning

confidence: 99%

“…The measurement of effect of resident training on postoperative morbidity has been more difficult to assess because of issues related to sample size, heterogeneity, and inherent complexity related to the procedures that have been studied. Investigator estimations of morbidity attributable to resident participation range from increased risk to no difference in risk, and, in some cases, a decreased risk for complications …”

Section: Discussionmentioning

confidence: 99%

“…Resident participation in thyroid surgery has been evaluated as part of larger heterogeneous pooled analyses and studies that included small patient sample sizes with varying proportions of total, subtotal, and hemithyroidectomy procedures …”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Impact of resident training on operative time and safety in hemithyroidectomy

et al. 2017

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Impact of resident training on operative time and safety in hemithyroidectomy

et al. 2017

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Trainee participation does not adversely affect the safety of thyroid surgery: Systematic review and meta‐analysis

et al. 2021

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Surgical traineeship is essential but must be safe for patients. In thyroid surgery, surgeon volume correlates with improved clinical/economic outcomes. However, it is presently unclear how far does trainee participation affect post‐thyroidectomy complication rates in real‐world and randomized data. We systematically searched four databases for associations of trainee participation with any post‐thyroidectomy outcome. We conducted univariate meta‐analyses, sensitivity analyses, and assessed publication bias qualitatively and quantitatively. We included 1 randomized and 15 observational studies from 3755 records, comprising 34 774 thyroid surgical patients. Trainee participation was associated with 12 min longer operative time, but not higher complication rates (hypoparathyroidism, recurrent laryngeal nerve palsy, hematoma, blood loss, return to operating room, hospitalization duration, readmission, and mortality). Sensitivity, publication bias, and multivariate analyses did not change our findings. Real‐world and limited randomized data suggest that trainee participation in thyroid surgery is safe, given adequate consultant supervision and appropriate case selection.

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Training in endocrine surgery

Gimm

Barczyński

Mihai

et al. 2019

Langenbecks Arch Surg

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Background/purpose In Europe, the Division of Endocrine Surgery (DES) determines the number of operations (thyroid, neck dissection, parathyroids, adrenals, neuroendocrine tumors of the gastro-entero-pancreatic tract (GEP-NETs)) to be required for the European Board of Surgery Qualification in (neck) endocrine surgery. However, it is the national surgical boards that determine how surgical training is delivered in their respective countries. There is a lack of knowledge on the current situation concerning the training of surgical residents and fellows with regard to (neck) endocrine surgery in Europe. Methods A survey was sent out to all 28 current national delegates of the DES. One questionnaire was addressing the training of surgical residents while the other was addressing the training of fellows in endocrine surgery. Particular focus was put on the numbers of operations considered appropriate. Results For most of the operations, the overall number as defined by national surgical boards matched quite well the views of the national delegates even though differences exist between countries. In addition, the current numbers required for the EBSQ exam are well within this range for thyroid and parathyroid procedures but below for neck dissections as well as operations on the adrenals and GEP-NETs.Conclusions Training in endocrine surgery should be performed in units that perform a minimum of 100 thyroid, 50 parathyroid, 15 adrenal, and/or 10 GEP-NET operations yearly. Fellows should be expected to have been the performing surgeon of a minimum of 50 thyroid operations, 10 (central or lateral) lymph node dissections, 15 parathyroid, 5 adrenal, and 5 GEP-NET operations.

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Education in thyroid surgery: a matched-pair analysis comparing residents and board-certified surgeons

Abstract: Major aspects of patient safety in thyroid surgery are not affected by resident participation. Thyroidectomies performed by RES are not significantly longer and reveal no differences in length of stay or complication rates. The economic burden of resident involvement is modest.

Cited by 9 publications

References 18 publications

Impact of resident training on operative time and safety in hemithyroidectomy

Impact of resident training on operative time and safety in hemithyroidectomy

Trainee participation does not adversely affect the safety of thyroid surgery: Systematic review and meta‐analysis

Training in endocrine surgery

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