Relationship between surgeon experience and adverse events in thyroid surgery

Main Article Content

Tommaso Loderer
Davide Beretta
Federico Cozzani
Elena Bonati
Matteo Rossini
Paolo Del Rio


thyroidectomy, surgical resident, learning curve, postoperative complications


In scientific literature there are numerous authors that have highlighted how the outcome of patients undergoing surgical treatment, such as intraoperative or postoperative complications, surgical time, mean hospital stay, is related to the surgeon's experience based on the number of cases treated per year for a specific disease.

In our study we decided to verify if, in our clinical practice, there are significant differences in postoperative outcomes between procedures performed by a senior surgeon, a young specialist or a surgical resident, evaluating if surgical experience affects positively either on intraoperative complications such as bleeding, hypocalcemia, dysphonia, or on surgical time, mean hospital stay and postoperative complications.

In this retrospective study we examined all cases of patients that underwent surgery for thyroid disease at our Operative Unit, from January 1, 2015 to December 31, 2019.

The analysis of our data highlights how the surgeon's experience affects the surgical outcome of patients undergoing lobectomy or total thyroidectomy.
Our conclusion was that a high volume center, like the one we are working in, with a correct selection of the patients,  allows to train a surgical resident guaranteeing both the surgical training of the doctor and the patients safety.


Download data is not yet available.
Abstract 200 | PDF Downloads 117


1. Sosa, J. A. et al. The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Annals of Surgery 228, 320–330 (1998).
2. Begg, C. B. et al. Variations in morbidity after radical prostatectomy. New England Journal of Medicine (2002) doi:10.1056/NEJMsa011788
3. Hu, J. C., Gold, K. F., Pashos, C. L., Mehta, S. S. & Litwin, M. S. Role of surgeon volume in radical prostatectomy outcomes. Journal of Clinical Oncology (2003) doi:10.1200/JCO.2003.05.169.
4. Schrag, D. et al. Surgeon volume compared to hospital volume as a predictor of outcome following primary colon cancer resection. Journal of Surgical Oncology (2003) doi:10.1002/jso.10244.
5. Birkmeyer, J. D. et al. Surgeon Volume and Operative Mortality in the United States. New England Journal of Medicine (2003) doi:10.1056/NEJMsa035205.
6. Boudourakis, L. D., Wang, T. S., Roman, S. A., Desai, R. & Sosa, J. A. Evolution of the surgeon-volume, patient-outcome relationship. Annals of Surgery 250, 159–165 (2009).
7. Helmstaedter, M., Briggman, K. L. & Denk, W. High-accuracy neurite reconstruction for high-throughput neuroanatomy. Nature Neuroscience (2011) doi:10.1038/nn.2868
8. Pecorelli, N. et al. Effect of Surgeon Volume on Outcome Following Pancreaticoduodenectomy in a High-Volume Hospital. Journal of Gastrointestinal Surgery (2012) doi:10.1007/s11605-011-1777-2
9. Archampong, D., Borowski, D., Wille-Jørgensen, P. & Iversen, L. H. Workload and surgeon´s specialty for outcome after colorectal cancer surgery. Cochrane Database of Systematic Reviews (2012) doi: 10.1002/14651858.cd005391.pub3.
10. Hauch, A., Al-Qurayshi, Z., Randolph, G. & Kandil, E. Total Thyroidectomy is Associated with Increased Risk of Complications for Low- and High-Volume Surgeons. Annals of Surgical Oncology (2014) doi:10.1245/s10434-014-3846-8.
11. Brusselaers, N., Mattsson, F. & Lagergren, J. Hospital and surgeon volume in relation to long-term survival after oesophagectomy: Systematic review and meta-analysis. Gut (2014) doi:10.1136/gutjnl-2013-306074.
12. Morche, J., Mathes, T. & Pieper, D. Relationship between surgeon volume and outcomes: A systematic review of systematic reviews. Systematic Reviews (2016) doi:10.1186/s13643-016-0376-4.
13. Adam, M. A. et al. Is there a minimum number of thyroidectomies a surgeon should perform to optimize patient outcomes? Annals of Surgery (2017) doi: 10.1097/SLA.0000000000001688.
14. Ferrari A., Manotti P.,Del Rio P.,Balestrino A.,Fabi M.. Project design for surgical department reorganization at hospital-university of Parma. Acta Biomed. 2018 Jun 7;89(2):165-172. doi: 10.23750/abm.v89i2.7142
15. Aspinall, S., Oweis, D. & Chadwick, D. Effect of surgeons’ annual operative volume on the risk of permanent Hypoparathyroidism, recurrent laryngeal nerve palsy and Haematoma following thyroidectomy: analysis of United Kingdom registry of endocrine and thyroid surgery (UKRETS). Langenbeck’s Archives of Surgery 404, 421–430 (2019).
16. Del Rio, P. et al. Postoperative hypocalcemia: Analysis of factors influencing early hypocalcemia development following thyroid surgery. BMC Surgery 18, 1–8 (2019).
17. Minuto MN, Reina S, Monti E, Ansaldo GL, Varaldo E.Morbidity following thyroid surgery: acceptable rates and how to manage complicated patients.J Endocrinol Invest. 2019 Nov;42(11):1291-1297. doi: 10.1007/s40618-019-01064-z. Epub 2019 May 23. Review.

Most read articles by the same author(s)

1 2 > >>