TY - JOUR
T1 - Does Surgical Volume Influence the Need for Second Surgery? A Pilot Study
AU - Judge, Paul D.
AU - Menousek, Joseph
AU - Schramm, Jordan C.
AU - Cusick, Robert
AU - Lydiatt, William
N1 - Funding Information:
The authors wish to thank Dr. Kyle Stansifer, MD (UNMC), for the critical reading of this article and Ms Valerie Shostrom (UNMC) for her assistance with statistical analysis of the data.
Publisher Copyright:
© The Authors 2017.
PY - 2017
Y1 - 2017
N2 - Objective: To examine outcomes of pediatric thyroidectomy in the context of training background, institution, and experience of the surgeon. Study Design: Case series with chart review. Setting: A tertiary academic medical center and a pediatric hospital. Subjects and Methods: Eighty-one thyroidectomy patients younger than 18 years. Outcomes were major complications (recurrent laryngeal nerve injury, permanent hypocalcemia, and wound infection), length of stay (LOS), and need for repeat surgery. Results: Eighty-one patients, 39 from the University of Nebraska Medical Center and 42 from the Children’s Hospital and Medical Center–Omaha, were identified over a 12-year time period. No difference was found in surgeon training (otolaryngology/head and neck surgery vs general/pediatric surgery) for complications (1 vs 1, odds ratio [OR] = 0.76, 95% confidence interval [CI] = [0.05, 13.1]), LOS >1 day (5 vs 13, OR = 0.39, 95% CI = [0.13, 1.24]), or need for second surgery (4 vs 7, OR = 1.47, 95% CI = [0.39, 5.49]). Higher surgeon volume (≥12 surgeries) was found to be significant for decreased need for second surgery (3 vs 8, OR = 6.67, 95% CI = [1.57, 27.17]). Patients of higher-volume surgeons were 4.2 times more likely to stay in the hospital 1 day or less compared with those patients operated on by surgeons with less experience (7 vs 11, 95% CI = [1.59, 15.0]). Conclusions: Need for second surgery in pediatric thyroidectomy may be predicted by surgical volume.
AB - Objective: To examine outcomes of pediatric thyroidectomy in the context of training background, institution, and experience of the surgeon. Study Design: Case series with chart review. Setting: A tertiary academic medical center and a pediatric hospital. Subjects and Methods: Eighty-one thyroidectomy patients younger than 18 years. Outcomes were major complications (recurrent laryngeal nerve injury, permanent hypocalcemia, and wound infection), length of stay (LOS), and need for repeat surgery. Results: Eighty-one patients, 39 from the University of Nebraska Medical Center and 42 from the Children’s Hospital and Medical Center–Omaha, were identified over a 12-year time period. No difference was found in surgeon training (otolaryngology/head and neck surgery vs general/pediatric surgery) for complications (1 vs 1, odds ratio [OR] = 0.76, 95% confidence interval [CI] = [0.05, 13.1]), LOS >1 day (5 vs 13, OR = 0.39, 95% CI = [0.13, 1.24]), or need for second surgery (4 vs 7, OR = 1.47, 95% CI = [0.39, 5.49]). Higher surgeon volume (≥12 surgeries) was found to be significant for decreased need for second surgery (3 vs 8, OR = 6.67, 95% CI = [1.57, 27.17]). Patients of higher-volume surgeons were 4.2 times more likely to stay in the hospital 1 day or less compared with those patients operated on by surgeons with less experience (7 vs 11, 95% CI = [1.59, 15.0]). Conclusions: Need for second surgery in pediatric thyroidectomy may be predicted by surgical volume.
KW - carcinoma
KW - papillary
KW - pediatric
KW - thyroidectomy
KW - volume
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U2 - 10.1177/2473974X17728257
DO - 10.1177/2473974X17728257
M3 - Article
C2 - 30480193
AN - SCOPUS:85086516356
VL - 1
JO - OTO Open
JF - OTO Open
SN - 2473-974X
IS - 3
ER -