Thyroid Surgery: A Comparison of Outcomes between Experts and Surgeons in Training
Thyroid Surgery: A Comparison of Outcomes between Experts and Surgeons in Training
复制标题
甲状腺手术：专家与外科医生培训结果的比较
DOI：
10.1067/mhn.2001.116790
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
M. Scarlett
中科院分区：
文献类型：
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作者：
S. Manolidis;M. Takashima;M. Kirby;M. Scarlett
目的：我们的目标是比较大型公立医院(MPH)的居民和大型私立医院(PH)的教职员工进行甲状腺手术的结果。方法：回顾1986~1998年间耳鼻咽喉科医生甲状腺手术的临床资料。纳入标准是数据的充分性和后续行动。对92例住院医师在公共卫生医院进行的甲状腺手术和181例住院医师在PH环境下进行的甲状腺手术进行了比较，比较了诊断研究的准确性、手术参数和并发症发生率的差异。结果：两组人群的人口学分布相似。MPH组出现症状的频率是对照组的两倍(45%比22%)。PH组接受甲状腺全切除术的比例较高(49%比32%)。两组患者的出血量、手术时间和住院天数相似。术前细针抽吸和术中冰冻切片结果显示敏感性和特异性具有可比性。两组均未观察到永久性声带麻痹。永久性低钙血症在PH组中更为常见(8.8%：PH比5.1%：MPH)。结论：以并发症发生率、住院时间和手术持续时间为衡量标准，在公共卫生医院接受耳鼻咽喉头颈外科培训的住院医师在一组具有非常相似特征的患者中进行甲状腺手术的结果与在公共卫生医院接受培训的教师相似。
OBJECTIVES: Our objective was to compare the results of thyroid surgery performed by residents in a large metropolitan public hospital (MPH) with those performed by faculty in a large private hospital (PH) setting. METHODS: All records of thyroid surgery performed by otolaryngologists for the period between 1986 and 1998 were reviewed. Inclusion criteria were adequacy of data and follow-up. Ninety-two thyroid procedures performed by residents in an MPH were compared with 181 thyroid operations in a PH setting performed by the faculty of these residents for differences in accuracy of diagnostic studies, operative parameters, and complication rates. RESULTS: The demographic distribution in both groups was similar. Presenting symptoms were twice as frequent in the MPH group (45% vs 22%). More total thyroidectomies were performed in the PH group (49% vs 32%). Blood loss, operative time, and hospitalization days were similar in both groups. Preoperative fine needle aspiration and intraoperative frozen section results showed sensitivities and specificities that were comparable. No permanent vocal cord paralysis was observed in either group. Permanent hypocalcemia was more frequent in the PH group (8.8%:PH vs 5.1%:MPH). CONCLUSIONS: The results of thyroid surgery performed by residents in training in an Otolaryngology-Head & Neck Surgery program in an MPH, measured by rates of complications, length of hospitalization, and duration of surgery, are similar to those of faculty at a PH setting in groups of patients with very similar characteristics.