Infographic1 min read·Published Jan 2023Older

Efecto del volumen quirúrgico del cirujano en cirugías pediátricas de tiroides: Una revisión sistemática

Infographic · Jan 2023 · 1 min read

In brief

Systematic review of 6,430 pediatric thyroidectomy cases examining the relationship between surgeon case volume and postoperative outcomes. High-volume surgeons (definitions varied from ≥9 to >200 annual thyroid cases) demonstrated significantly lower complication rates and shorter hospital stays compared to low-volume surgeons.

Higher surgeon volume correlates with better outcomes in pediatric thyroidectomy, including fewer complications and shorter hospital stays.
Definitions of 'high-volume' pediatric thyroid surgeon vary widely, ranging from ≥9 to >200 annual thyroid cases.
Transient hypocalcemia is the most common complication, occurring in 11-74% of cases depending on surgeon volume and technique.
Concentrating pediatric thyroidectomy cases to fewer, higher-volume surgeons may improve patient outcomes.
Most pediatric thyroidectomies are total thyroidectomies (55%) performed for malignancy (42%) or hyperthyroidism/thyroiditis (41%).

Written by the GCMD Library team from the infographic.

A clinical comparison chart displaying three treatment modalities arranged vertically with accompanying icons and statistics. Each section uses distinct color coding (blue, green, and purple) and includes graphical representations of success rates, complication profiles, and procedural characteristics. Bar charts and percentage indicators provide quantitative comparisons across the three approaches.

Infografía por Em Tombash

"Efecto del volumen quirúrgico del cirujano en cirugías pediátricas de tiroides: Una revisión sistemática" Sydney L. Olson et.al.

Articulo Completo: https://www.jpedsurg.org/article/S0022-3468(21)00834-4/fulltext

Authors: Sydney L. Olson, Martha-Conley E. Ingram, Peter M. Graffy, Peggy M. Murphy, Yao Tian, Jill H. Samis, Jami L. Josefson, Jeffery C. Rastatter, Mehul V. Raval

Abstract

Background

Pediatric thyroidectomy has been identified as a surgical procedure that may benefit from concentrating cases to high-volume surgeons. This systematic review aimed to address the definition of “high-volume surgeon” for pediatric thyroidectomy and to examine the relationship between surgeon volume and outcomes.

Methods

PubMed, Embase, Cochrane Library, Scopus, Web of Science, ClinicalTrials.gov, and OpenGrey databases were searched for through February 2020 for studies which reported on pediatric thyroidectomy and specified surgeon volume and surgical outcomes.

Results

Ten studies, encompassing 6430 patients, were included in the review. Five single-center retrospective studies reported only on high-volume surgeons, one single center retrospective study reported on only low-volume surgeons, and four national database studies (2 cross sectional, 2 retrospective reviews) reported outcomes for both high-volume and low-volume surgeons. Majority of patients underwent total thyroidectomy (54.9%); common indications for surgery were malignancy (41.7%) and hyperthyroidism/thyroiditis (40.5%). Rates of transient hypocalcemia (11.4% - 74.2%), transient recurrent laryngeal nerve injury (0% - 9.7%), and bleeding (0.5% - 4.3%) varied across studies. Definitions for high-volume pediatric thyroid surgeons ranged from ≥9 annual pediatric thyroid operations to >200 annual thyroid operations (with >30 pediatric cases). Four studies reported significantly better outcomes, including lower post-operative complications and shorter length of hospital stay, for patients treated by high-volume surgeons.

Conclusions

Despite significant variation in caseloads to define volume, pediatric thyroid patients have generally better outcomes when operated on by higher volume surgeons. Concentration thyroidectomy cases to a smaller cohort of surgeons within pediatric practices may confer improved outcomes.

Level of evidence

Systematic Reviews and Meta-Analyses; Level IV

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