Quality control study of benign and malignant goitre 1998. A prospective multicenter study with 7617 patients

A quality control study was undertaken on 7265 patients with benign goitre and 352 patients with malignant goitre who were surgically treated between 1.1.98 and 31.12.98. 3 hospital groups were defined according to surgical w orkload: Group 1: < 50 operations/yr; Group 2: 50-150 operations/yr; Group 3: > 150 operations/yr. The temporary rate of recurrent laryngeal nerve (RL N) palsies for benign goitre was 3.9% and the permanent 1.1%. For malignant goitre the rates were 12.8% and 6.8% respectively. The rate of temporary ( p < 0.040) and permanent (0.003) palsies after surgery for benign goitre wa s lower in group 3 compared to group 1 and 2. There were too few cases for statistical analysis of the malignant goitres. After benign goitre surgery a transient hypocalcaemia rate of 6.3% and a permanent of 1.1% were observe d. For malignant goitre the incidence was 23.8% and 7.1%, respectively. A s ignificantly increased rate of permanent hypocalcaemia (p < 0.003) was demo nstrated in group 3 after surgery for multinodular goitre. Centres in group 3 made more extended (smaller thyroid remnants) resections (p < 0.01) with the equivalent rate of general complications. The average inpatient stay f or malignant goitres was 13.1 days and for benign goitres 8.7 days. On aver age, patients with bilateral resections for benign goitre stayed 0.4 days l onger in hospital than those with unilateral procedures. Prophylactic antib iotics were administered to 2.1% of patients and 94.6% received thrombosis prophylaxis.