Thyroid surgery: A comparison of outcomes between experts and surgeons in training

OBJECTIVES: Our objective was to compare the results of thyroid surgery per formed by residents in a large metropolitan public hospital (MPH) with thos e performed by faculty in a large private hospital (PH) setting. METHODS: All records of thyroid surgery performed by otolaryngologists for the period between 1986 and 1998 were reviewed. Inclusion criteria were ade quacy of data and follow-up. Ninety-two thyroid procedures performed by res idents in an MPH were compared with 181 thyroid operations in a PH setting performed by the faculty of these residents for differences in accuracy of diagnostic studies, operative parameters, and complication rates. RESULTS: The demographic distribution in both groups was similar. Presentin g symptoms were twice as frequent in the MPH group (45% vs 22%). More total thyroidectomies were performed in the PH group (49% vs 32%). Blood loss, o perative time, and hospitalization days were similar in both groups. Preope rative fine needle aspiration and intraoperative frozen section results sho wed sensitivities and specificities that were comparable. No permanent voca l cord paralysis was observed in either group. Permanent hypocalcemia was m ore frequent in the PH group (8.8%:PH vs 5.1%:MPH). CONCLUSIONS: The results of thyroid surgery performed by residents in train ing in an Otolaryngology-Head & Neck Surgery program in an MPH, measured by rates of complications, length of hospitalization, and duration of surgery , are similar to those of faculty at a PH setting in groups of patients wit h very similar characteristics.