Key result
Trainee involvement in thyroidectomy is associated with similar complication rates but ~19 minutes longer operative time.
Why the study?
The impact of surgical trainee involvement on morbidity and resource use during thyroidectomy was unclear over a long-term period.
Does the involvement of a surgical trainee increase complication rates in patients undergoing thyroidectomy?
Cohort (n=2,858)
Does the involvement of a surgical trainee increase complication rates in patients undergoing thyroidectomy?
Absolute Event Rate: 13.1% vs 13.8%
Surgical trainees can be safely taught operative skills under supervision without increasing patient complications, though it results in a 15% increase in operative time.
Supports supervised trainee involvement in thyroidectomy without added complications; extends training safety data but leaves open efficiency and generalizability questions.
The morbidity rate for 2858 patients undergoing thyroidectomy over the 10 year period January 1977-December 1986 was examined and related to the involvement of a surgical trainee in the operative procedure. There was no overall difference in specific complication rates related to the surgical procedure, being 13.8% when the procedure was undertaken by a consultant, and 13.1% when a surgical trainee was involved in the procedure. There was a significant increase (P = 0.0025) in operative time increasing from 127 min for the consultant to 146 min when the trainee was involved (a 15% increase). There was no significant difference in bed stay for any of the groups. Surgical trainees can be safely taught operative skills under supervision without risk of increased complications. There is a cost, however, to the hospital system in terms of increased demands on time and operative facilities.
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Martin et al. (1989) conducted a cohort in Thyroidectomy (n=2,858). Surgical trainee involvement vs. Consultant only was evaluated on Specific complication rates. Surgical trainee involvement in thyroidectomy yielded similar complication rates to consultant-only procedures (13.1% vs 13.8%), but significantly increased operative time (146 vs 127 min; P=0.0025).
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