Surgeon volume in thyroid surgery: Surgical efficiency, outcomes, and utilization

Area of Science:

• Endocrinology
• Surgical Oncology
• Health Services Research

Background:

• Surgeon volume is a recognized factor influencing surgical outcomes.
• Understanding the impact of high-volume surgeons on thyroidectomy efficiency and patient safety is crucial for optimizing healthcare delivery.

Purpose of the Study:

• To evaluate the association between high-surgeon volume and improved surgical efficiency, 30-day patient outcomes, and hospital resource utilization in thyroidectomy procedures.

Main Methods:

• A retrospective observational cohort study was conducted from 2008-2013.
• 3,135 patients undergoing hemithyroidectomy or total thyroidectomy by high-volume surgeons were propensity score-matched to 3,135 patients treated by low-volume surgeons.
• Outcomes assessed included 30-day complications, mortality, readmissions, emergency department visits, outpatient procedure rates, surgical time, and length of stay.

Main Results:

• High-volume surgeons demonstrated significantly better outcomes for both hemithyroidectomies and total thyroidectomies.
• For hemithyroidectomies, high-volume surgeons had fewer readmissions (2.7% vs 7.0%), more outpatient procedures (46% vs 29%), and shorter lengths of stay and surgical times.
• For total thyroidectomies, high-volume surgeons had lower complication rates (5.7% vs 7.5%), fewer hypocalcemia cases (4.9% vs 7.0%), less surgical site infections (0.3% vs 1.0%), more outpatient procedures (13% vs 3%), and shorter lengths of stay and surgical times.

Conclusions:

• High-volume surgeons significantly enhance patient safety and surgical efficiency in thyroidectomy procedures.
• The expertise of high-volume surgeons leads to reduced complications, shorter recovery times, and increased utilization of outpatient care.
• These findings suggest that the benefits of high-volume surgeons in thyroid surgery may be underutilized in some healthcare settings.