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Thyroid surgery: changing patterns of practice.

机译:甲状腺手术:改变实践方式。

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摘要

OBJECTIVE: The practice of thyroidectomy has evolved over the past 10 years with the introduction of minimally invasive surgery, laryngeal nerve monitoring, and outpatient surgery. We sought to investigate corresponding trends in the disciplines performing thyroid surgery. METHODS AND MATERIALS: The authors conducted a nonrandomized, case-controlled comparison of surgical volumes and systematic analysis of publication volumes. Two surrogates for the proportion of thyroidectomies being performed by otolaryngologists-head and neck surgeons (OHNS) and general surgeons (GS) were chosen: 1) the operative case logs of graduates from American training programs in OHNS and GS from 1995 through 2004 were compared; and 2) the number of scientific articles published relating to thyroid surgery were systematically queried for two timeframes (1990-1994 and 2000-2004). RESULTS: There was a gradual increase in the mean number of thyroidectomies performed by GS residents from 13.2 in 1995 to 18.2 in 2004. During the same timeframe, the mean number of thyroidectomies performed by OHNS residents more than doubled from 15.0 to 33.5. The number of American GS thyroid publications from 1990 to 1994 was 79, compared with 98 in the period 2000 to 2004, representing a 24% increase. During the same timeframe, the number of American OHNS articles increased from 14 to 49 (a 250% increase). The relative proportion of thyroid publications authored by American otolaryngologists more than doubled from 15.1% to 33.3% (P = .0017). CONCLUSIONS: A clear trend is emerging in the pattern of thyroid surgery in that a growing proportion of publications are being authored by otolaryngologists compared with general surgeons, and the average number of procedures performed by graduating chief residents is now 84% higher in otolaryngology compared with general surgery.
机译:目的:在过去的十年中,随着微创手术,喉神经监测和门诊手术的引入,甲状腺切除术的发展得到了发展。我们试图调查进行甲状腺手术的学科的相应趋势。方法和材料:作者对手术量进行了非随机,病例对照的比较,并对出版物量进行了系统分析。选择了两种由耳鼻喉科医生进行的甲状腺切除术比例的替代方法-头颈外科医师(OHNS)和普通外科医师(GS):1)比较了1995年至2004年美国OHNS和GS培训计划的毕业生的手术病例日志; 2)系统地查询了两个时间范围(1990-1994年和2000-2004年)有关甲状腺手术的科学文章的数量。结果:GS居民进行的甲状腺切除术的平均数量从1995年的13.2逐渐增加到2004年的18.2。在同一时间范围内,OHNS居民进行的甲状腺切除术的平均数量从15.0增加到33.5倍以上。 1990年至1994年,美国GS甲状腺出版物的数量为79种,而2000年至2004年为98种,增长了24%。在同一时间范围内,美国OHNS文章的数量从14条增加到49条(增加了250%)。美国耳鼻喉科医生撰写的甲状腺出版物的相对比例从15.1%增至33.3%(P = 0.0017),翻了一番以上。结论:与普通外科医师相比,甲状腺外科手术的趋势正在出现明显的趋势,即耳鼻喉科医师所发表的出版物比例越来越高,而与之相比,主要居民的平均手术次数比耳鼻喉科医师高84%。普外科。

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