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The Paddocks
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Thyroid
Surgeon Outcome Data

In 2013 the British Association of Endocrine and Thyroid Surgeons published for the first time open-source outcome data on the leading thyroid surgeons in the UK.

The database which can be viewed contains all the cases undertaken by participating surgeons and has facilitated research and development and we now hope it will drive up standards.

I have published below some of the key graphs relating to my personal practice.  The graphs are downloaded from the National Database presentation website which is available through (www.baets.org.uk).

 

1. Volume of thyroid surgery

 

We all know that the more operations a surgeon does the better they get at it.  Complications from thyroid surgery are very rare but damage to the recurrent nerve in particular can be troublesome.  There is clear evidence that the more operations a surgeon does the lower the rate of nerve injury.

My personal figures show 261 operations performed in the 3 year period 2009-2012.  This is as you can see significantly higher than 90% of UK surgeons.

In the calendar year 2013 I undertook 120 thyroid procedures - this is amongst the highest volume in the UK

 

 

2. Length of stay after thyroid surgery

I personally feel this is an important measure and have been at the forefront of developing and undertaking daycase thyroid surgery for the last 10 years.

I see no reason why patients after high quailty thyroid surgery should stay in hospital.  Indeed the surgeon and anaesthetist need to work together to ensure patients are awake, alert and pain free so they can go home at the end of the day - in many cases in my practice after a few hours.

The results of what is a team effort can be seen in the graph below where my patients stay far shorter periods in the hospital than the national average.

Ask yourself - why should I stay and why do I need to stay?  The answer to the latter may be that muscles have been cut in the neck or your surgeon is not as experienced in daycase techniques.

 

 

3. Late hypocalcaemia after thyroid surgery

Hypocalcaemia (low calcium levels) after thyroid surgery is an annoying and common problem.  Hypocalcaemia occurs when all 4 parathyroid glands fail to function properly after thyroid surgery - potentially due to damage from the surgery itself and therefore by the surgeon.

There is now clear evidence that high volume thyroid surgeons have a lower incidence of this complication than others.

My personal exceedingly low rate for this complication is illustrated in the funnel plot below.  The dots represent individual surgeons - my dot is coloured in blue.  The rate for my practice is 0.5% of patients suffering late hypocalcaemia compared to the national average rate of 7%.

 

 
Daycase Thyroid Surgery

http://daysurgeryuk.net/bads/joomla/files/Journal/16.1/16.1.9-12%20HowatThyroid.pdf

 
Thyroid Surgery Video

The following video shows Mr McLaren undertaking a thyroid operation.  This video demonstrates the use of modern technology in the form of the Harmonic Focus device.  Mr McLaren uses this device for all thyroid operations. There is evidence that this reduces blood loss, shortens the operation time and may reduce complications from the surgery.

 

http://www.youtube.com/watch?v=1CnqbDEzOJM

 

 

 

 
Thyroid Nodules

What are they?
Nodules are lumps within the thyroid gland. They are common and only 5% are malignant. Thyroid nodules require careful assessment as described below.

What are the causes of thyroid lumps?
Common causes include cysts, adenomas and colloid nodules with malignant causes being relatively uncommon.

Read more...
 
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