Thyroid Surgery Volumen and Outcomes

  • Introduction:
    • Although the association between annual surgeon total thyroidectomy volume and clinical outcomes is well established, published methods typically group surgeons into volume categories.
    • The volume-outcomes association is likely continuous, but little is known about the point at which the annual surgeon procedure volumes begin to beassociated with a decrease in complication rates.
  • Multiple studies have demonstrated the relationship between surgeon volume and improved patient outcomes.
  • This is no different for thyroid surgery; when procedures are performed by high-volume surgeons, patients have decreased rates of endocrine-specific complications (e.g., transient and permanent hypoparathyroidism and recurrent laryngeal-nerve injury), shorter hospital stays, and lower rates of readmission.
  • Previous studies have varied with respect to the definition of a high-volume surgeon, ranging from a threshold of 30 to 100 thyroidectomies per year:
    • One recent study demonstrated that the likelihood of experiencing a complication decreased with increased surgeon volume, up to 26 total thyroidectomies per year.
  • The intent of the current study was to examine the association between surgeon volume and patient outcomes for total thyroidectomy, with the hypothesis that the optimal threshold is continuous, with no defined cut point defining a high-volume surgeon

JAMA Otolaryngol Head Neck Surg. 2019 Jul 25. doi: 10.1001/jamaoto.2019.1752