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[Regional function in thyroid surgery. Assessment of the specialty function and surgical risk factors]
Esbern Friis1, Charlotte Louise Mollerup, Mogens Blichert-Toft
1H:S Rigshospitalet, Hoved-Ortocenteret, Endokrin- og Mammakirurgisk Klinik CE, København.
Introduction:
It is recommended that a subset of benign thyroid operations, defined by The Danish National Board as potentially complicated thyroid surgery, is referred to surgical units specialised in thyroid surgery. The aim of the present study was to compare indications for operation and operative complications in patients referred as high risk operations with patients referred from the primary catchment area to a surgical unit specialising in thyroid surgery.
Material And Methods:
The study includes 570 consecutive operations performed between January 1st 1994 and December 31st 1998.
Results:
Out of 570 operations, 239 were referred as high risk operations. Complications were significantly more frequent after high risk operations. Delayed wound bleeding requiring reoperation occurred in 3.3 per cent vs. 0.3 per cent of cases (p = 0.01), whereas the risk of unilateral recurrent nerve palsy (1 per cent vs 0.5 per cent, p = 0.3) and permanent hypocalcemia in 1.7 per cent vs. 0 per cent (p = 0.06) was statistically insignificant between the two risk groups.
Discussion:
The study confirms an elevated risk of complications in the defined high risk group and demonstrates that the referring hospitals comply with the recommendations laid down by the National Board of Health.