[Quality assurance study in thyroid gland surgery. Initial comparative intermediate -term results for benign thyroid...

In 1998 the East German Association for Quality Securing of Surgery performed a study to evaluate the standard of performance of surgical treatment for benign goiter. In total, 46 hospitals participated and 6,029 operations could be analysed. The documentation was based on a detailed registration sheet and recorded items of preoperative complaints, diagnostic procedures, intraoperative findings with operative strategy, postoperative complications and definitive histology. All hospitals were divided into three groups regarding their number of surgical performances for benign goiter (< 50 operations, 50-150 operations, > 150 operations) to assess their training and expertise. Indications for surgical treatment were similar in all three groups with 78% for multinodular goiter and 19% for uninodular goiter. There was no statistical difference in distribution for M. Basedow, recurrent goiter or thyroid carcinoma. Hospitals with more than 150 operations per year for benign goiter performed statistical significant more extended procedures with routinely preparation of the laryngeal recurrent nerve and parathyroid glands. There was no statistical significant difference regarding postoperative complications. Because of the not finished check up (follow up 6 months postoperative), results for temporary nerve palsies (3.9%) and temporary hypoparathyroidism (6.3%) could only be stated.