HYPERTHYROIDISM: SURGEON’S EXPERIENCE IN ENDOCRINE SURGERY IS A KEY FACTOR IN THE PROCESS OF THERAPEUTIC DECISION-MAKING

…Whenever surgery is selected as treatment of hyperthyroidism one should consider the use of expert high-volume thyroid surgeons with on average lower risk of complications; lack of that expertise should be considered against the known risk of alternative choices….…If surgery is chosen as the primary therapy for Graves’ disease, the patient should be referred to a high-volume thyroid surgeon (strong recommendation)….…Average complication rates, length of hospital stay, and cost are reduced when the  operation is performed by a surgeon who conducts many thyroidectomies. A significant association is seen between increasing thyroidectomy volume and improved patient outcome; this association is robust and is more pronounced with an increasing number of thyroidectomies. The surgeon should be thoroughly trained in the procedure, have an active practice in thyroid surgery, and have conducted a significant number of thyroidectomies with a low frequency of complications…
American Thyroid Association, 2016


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