title: Supervised surgical trainees perform thyroid surgery for Graves' disease safely.
abstract: BACKGROUND
  There is little information about the effect of operative experience and supervision of trainees on long-term outcomes after thyroid resection for Graves' disease (GD). The aim of this study was to compare the morbidity rate after thyroid resection performed by trainees vs consultant surgeons.
  
  
  METHODS
  Based on a cross-sectional design analysis with a median follow-up of 96 months (range, 12-216 months), long-term outcomes for 111 patients operated on by consultants were compared with those of 42 patients operated on by supervised trainees in an academic teaching hospital between 1987 and 2002.
  
  
  RESULTS
  Of the 111 patients operated on by the consultants, there were 25 (21.6%) cases of transient and 12 (10.8%) cases of permanent hypocalcemia and 10 (9.0%) cases of transient and 1 (0.9%) case of permanent recurrent laryngeal nerve (RLN) palsy. Of the 42 patients operated upon by the supervised trainees, there were 8 (21.4%) cases of transient and no permanent hypocalcemia, 3 (7.1%) cases of transient, and 1 (2.3%) case of permanent RLN palsy. Permanent complication rate of the entire group was low, and the grade of the primary surgeon made no difference in the occurrence of complications (P>0.05).
  
  
  CONCLUSIONS
  Supervised trainees can perform thyroid surgery for GD safely if a standardized surgical teaching program is available.
authors.affiliation: Department of Visceral, Thoracic, and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, 35043 Marburg, Germany. hassan@med.uni-marburg.de
authors.forename: Iyad
authors.initials: I
authors.lastname: Hassan
authors.forename: Michael
authors.initials: M
authors.lastname: Koller
authors.forename: Conrad
authors.initials: C
authors.lastname: Kluge
authors.forename: Sebastian
authors.initials: S
authors.lastname: Hoffmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Zielke
authors.forename: Matthias
authors.initials: M
authors.lastname: Rothmund
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000601:surgery*; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D013965:Thyroidectomy / Q000009:adverse effects / Q000193:education* / Q000379:methods; D016896:Treatment Outcome