Trainee participation does not adversely affect the safety of thyroid surgery: Systematic review and meta-analysis
- PMID: 34708904
- DOI: 10.1002/hed.26900
Trainee participation does not adversely affect the safety of thyroid surgery: Systematic review and meta-analysis
Abstract
Surgical traineeship is essential but must be safe for patients. In thyroid surgery, surgeon volume correlates with improved clinical/economic outcomes. However, it is presently unclear how far does trainee participation affect post-thyroidectomy complication rates in real-world and randomized data. We systematically searched four databases for associations of trainee participation with any post-thyroidectomy outcome. We conducted univariate meta-analyses, sensitivity analyses, and assessed publication bias qualitatively and quantitatively. We included 1 randomized and 15 observational studies from 3755 records, comprising 34 774 thyroid surgical patients. Trainee participation was associated with 12 min longer operative time, but not higher complication rates (hypoparathyroidism, recurrent laryngeal nerve palsy, hematoma, blood loss, return to operating room, hospitalization duration, readmission, and mortality). Sensitivity, publication bias, and multivariate analyses did not change our findings. Real-world and limited randomized data suggest that trainee participation in thyroid surgery is safe, given adequate consultant supervision and appropriate case selection.
Keywords: evidence-based medicine; meta-analysis; surgical complications; surgical education; thyroidectomy.
© 2021 Wiley Periodicals LLC.
References
REFERENCES
-
- Nouraei SA, Virk JS, Middleton SE, et al. A national analysis of trends, outcomes and volume-outcome relationships in thyroid surgery. Clin Otolaryngol. 2017;42(2):354-365.
-
- Sosa JA, Bowman HM, Tielsch JM, Powe NR, Gordon TA, Udelsman R. The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg. 1998;228(3):320-330.
-
- Lee LC, Reines HD, Domanski M, Zapanta P, Robinson L. General surgery and otolaryngology resident perspectives on obtaining competency in thyroid surgery. J Surg Educ. 2012;69(5):593-598.
-
- Birkmeyer JD, Stukel TA, Siewers AE, Goodney PP, Wennberg DE, Lucas FL. Surgeon volume and operative mortality in the United States. N Engl J Med. 2003;349(22):2117-2127.
-
- Casson AG, van Lanschot JJ. Improving outcomes after esophagectomy: the impact of operative volume. J Surg Oncol. 2005;92(3):262-266.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources