Complications of total thyroidectomy performed by surgical residents versus specialist surgeons.
OBJECTIVE
Surgeon inexperience has been defined as a significant predictor of deleterious outcome in thyroid surgery; however, the safety of training programs in which residents are the primary surgeons is controversial. The objective of this prospective study was to compare the complication rates of total thyroidectomy (TT) performed by residents with those of TT performed by specialist surgeons in similar patient groups.


METHODS
Between April 2001 and May 2007, 144 patients underwent TT at our hospital. For 75 operations, the primary surgeon was a resident under the direct supervision of the attending surgeon, and for 69 operations, the primary surgeon was the experienced attending surgeon. Pre-and postoperative vocal cord examinations and serum calcium level evaluations were carried out in all patients.


RESULTS
The rates of temporary (unilateral) recurrent laryngeal nerve (RLN) palsy were 2.66% vs 2.17% after TT performed by the residents vs the attending surgeon, respectively. There were no significant differences in the incidences of temporary hypoparathyroidism (20% vs 20.28%), permanent (unilateral) RLN palsy, hematoma, infection, seroma, and incidental parathyroidectomy between the two groups.


CONCLUSIONS
The complication rates of TT performed by residents and attending surgeons were similar. Thus, residents can perform TT safely and effectively under the direct supervision of a senior surgeon. Ultimately, strict adherence to the contemporary principles of thyroid surgery is of paramount importance.
Emre
Ali U
AU
Department of Surgery, Zonguldak Karaelmas University School of Medicine, Arastirma ve Uygulama Hastanesi Bashekimligi, 67600, Kozlu, Zonguldak, Turkey.
Cakmak
Güldeniz Karadeniz
GK
Tascilar
Oge
O
Ucan
Bülent H
BH
Irkorucu
Oktay
O
Karakaya
Kemal
K
Balbaloglu
Hakan
H
Dibeklioglu
Sami
S
Gul
Mesut
M
Ankarali
Handan
H
Comert
Mustafa
M
D016009:Chi-Square Distribution; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D013038:Specialization; D013965:Thyroidectomy / Q000592:standards*; D014826:Vocal Cord Paralysis / Q000453:epidemiology*