Terris David J, Seybt Melanie W, Siupsinskiene Nora, Gourin Christine G, Chin Edward
Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, Georgia 30912-4060, USA.
Laryngoscope. 2006 Jun;116(6):911-5. doi: 10.1097/01.mlg.0000214855.34706.34.
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.
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).
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).
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.
在过去10年中，随着微创手术、喉返神经监测和门诊手术的引入，甲状腺切除术的实践发生了演变。我们试图研究实施甲状腺手术的学科中的相应趋势。
作者进行了一项非随机、病例对照的手术量比较以及出版物数量的系统分析。选择了两个代表耳鼻咽喉头颈外科医生（OHNS）和普通外科医生（GS）实施甲状腺切除术比例的指标：1）比较了1995年至2004年美国OHNS和GS培训项目毕业生的手术病例记录；2）系统查询了两个时间段（1990 - 1994年和2000 - 2004年）发表的与甲状腺手术相关的科学文章数量。
GS住院医师实施的甲状腺切除术平均数量从1995年的13.2例逐渐增加到2004年的18.2例。在同一时间段内，OHNS住院医师实施的甲状腺切除术平均数量从15.0例增加到33.5例，增加了一倍多。1990年至1994年美国GS关于甲状腺的出版物数量为79篇，2000年至2004年为98篇，增长了24%。在同一时间段内，美国OHNS的文章数量从14篇增加到49篇（增长了250%）。美国耳鼻咽喉科医生撰写的甲状腺出版物的相对比例从15.1%增加到33.3%以上（P = 0.0017）。
甲状腺手术模式中出现了一个明显的趋势，即与普通外科医生相比，耳鼻咽喉科医生撰写的出版物比例越来越高，并且与普通外科相比，耳鼻咽喉科即将毕业的总住院医师平均实施的手术数量现在高出84%。
