Choose a Thyroid Surgeon Who Does Dozens of Operations a Year

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For surgeons who do thyroid operations, practice makes perfect.

Thyroidectomy, the removal of the thyroid gland, is a common operation, performed more than 130,000 times a year in the United States, but doing it right is difficult.

Researchers, writing in the Annals of Surgery, studied 16,954 patients, about half of whom underwent thyroidectomy for cancer and half for benign conditions.

After adjusting for age, sex, diagnosis and other factors, they found that the risk of complications went down as the number of operations the surgeon performed went up. There was an 87 percent risk of complications for surgeons who did one operation a year; 68 percent for two to five; 42 percent for six to 10; 22 percent for 11 to 15; and 10 percent for 16 to 20. Only 3 percent of patients of surgeons who did 21 to 25 operations a year had complications; those who did more had a similar rate of complications.

Patients of high-volume surgeons had fewer complications not only with the thyroid gland itself, but also less bleeding and wound infection, and fewer respiratory problems. They also spent less time in the hospital after surgery.

The senior author, Dr. Julie A. Sosa, the chief of endocrine surgery at Duke, said that a patient has to be his own advocate. “If you can only ask only one question,” she said, “the most important is: ‘Who are the surgeons who do more than 25 thyroidectomies a year?’ ”