American Association of Endocrine SurgeonAvoidable reoperations for thyroid and parathyroid surgery: Effect of hospital volume
Section snippets
Methods
All patients undergoing thyroid and parathyroid surgery between 1999 and 2007 at the Cleveland Clinic by 3 endocrine surgeons were retrospectively reviewed. For each reoperation, the hospital where the initial operation took place was identified.
Preoperative imaging studies, intraoperative findings, and histopathology reports of both the initial and subsequent operations were analyzed to classify each reoperation as avoidable or unavoidable using a set of objective criteria (Table I). This set
Study group
During the study period, 280 patients underwent reoperative thyroid and parathyroid procedures; 227 underwent 1 and 53 patients underwent multiple reoperations, for a total of 395 reoperative procedures. Reoperations originating from our institution were included in the analysis. The hospital where the initial operation occurred was available for 335 (85%) of these cases. The remaining 60 cases were excluded from further analysis.
Referring hospital characteristics
Initial operations occurred at 49 different hospitals. Of these,
Discussion
To our knowledge, this is the first study looking at the incidence of avoidable reoperations in thyroid and parathyroid surgery and how it relates to hospital volume. It is also the first study to propose a set of objective criteria with which to classify thyroid and parathyroid operations as avoidable or unavoidable. Although it may seem as though the indications for parathyroid and thyroid reoperations may be widely variable, the set of 10 criteria for parathyroid cases and 8 for thyroid
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