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Updated: Mar 19, 2026
Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Surgeon volume in thyroid surgery: Surgical efficiency, outcomes, and utilization
Charles Meltzer1, Marc Klau2, Deepak Gurushanthaiah3
1Permanente Medical Group, Santa Rosa, California, U.S.A.. charles.meltzer@kp.org.
Objectives/Hypothesis:
To test our hypothesis that high-surgeon volume is associated with improved surgical efficiency and 30-day outcomes, and lower hospital utilization.
Study Design:
Retrospective observational cohort, 2008-2013.
Methods:
A total of 3,135 patients with hemithyroidectomy or total thyroidectomy performed by a high-volume surgeon, propensity score-matched to 3,135 patients with the same procedure performed by a low-volume surgeon. All-cause 30-day complication, mortality, readmission, and emergency department visit rates, proportion of outpatient procedures, cut-to-close time, and length of stay were assessed.
Results:
Hemithyroidectomies: Compared to low-volume surgeons, high-volume surgeons had fewer readmitted patients (2.7% vs. 7.0%, P < .05), more outpatient procedures (46% vs. 29%, P < .05), and shorter lengths of stay (mean [standard deviation] 16.6 [22.1] vs. 21.7 [27.5] hours, P < .05) and surgical (cut-to-close) times (1.7 [0.7] vs. 2.0 [1.1] hours, P < .05). Total thyroidectomies: High-volume surgeons had lower rates of all surgery-related complications (5.7% vs. 7.5%, P < .05), hypocalcemia (4.9% vs. 7.0%, P < .05), surgical site infections (0.3% vs. 1.0%, P < .05), more outpatient procedures (13% vs. 3%, P < .05), shorter lengths of stay (29.9 [32.8] vs. 39.8 [36.2] hours, P < .05), and cut-to-close times (2.4 [1.1] vs. 3.0 [1.7] hours, P < .05).
Conclusion:
High-volume surgeons improve patient safety and have the potential to contribute to organizational efficiency that may be underutilized in some settings.
Level Of Evidence:
4. Laryngoscope, 126:2630-2639, 2016.
