Supervised surgical trainees perform thyroid surgery for Graves' disease safely

There is little information about the effect of operative experience and supervision of trainees on long-term outcomes after thyroid resection for Graves' disease (GD). The aim of this study was to compare the morbidity rate after thyroid resection performed by trainees vs consultant surgeons.

Based on a cross-sectional design analysis with a median follow-up of 96 months (range, 12-216 months), long-term outcomes for 111 patients operated on by consultants were compared with those of 42 patients operated on by supervised trainees in an academic teaching hospital between 1987 and 2002.

Of the 111 patients operated on by the consultants, there were 25 (21.6%) cases of transient and 12 (10.8%) cases of permanent hypocalcemia and 10 (9.0%) cases of transient and 1 (0.9%) case of permanent recurrent laryngeal nerve (RLN) palsy. Of the 42 patients operated upon by the supervised trainees, there were 8 (21.4%) cases of transient and no permanent hypocalcemia, 3 (7.1%) cases of transient, and 1 (2.3%) case of permanent RLN palsy. Permanent complication rate of the entire group was low, and the grade of the primary surgeon made no difference in the occurrence of complications (P>0.05).

Supervised trainees can perform thyroid surgery for GD safely if a standardized surgical teaching program is available.