Kuo Jennifer H, Pasieka Janice L, Parrack Kevin M, Chabot John A, Lee James A
Section of Endocrine Surgery, Department of Surgery, Columbia University, New York, NY.
Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
Surgery. 2014 Dec;156(6):1461-69; discussion 1469-70. doi: 10.1016/j.surg.2014.08.025. Epub 2014 Nov 11.
Endocrine surgery is a specialty that is evolving constantly. In this study, we sought to delineate the practice patterns of surgeons taking care of endocrine diseases in present-day academic centers.
A review of the Faculty Practice Solutions Center database was conducted for the years 2005, 2009, and 2013. Practice patterns were determined by International Classification of Diseases, 9th Revision and Current Procedural Terminology codes, and analyzed for practice composition, regional variability, and volume of endocrine operations.
Of 97 national academic centers, 52 were identified to have 120 practicing American Association of Endocrine Surgeons (AAES) surgeons in the study. On average, endocrine operations comprise ∼65% of the AAES surgeon's practice, and 51% are considered high-volume surgeons for thyroidectomy, parathyroidectomy, and adrenalectomy. Most non-AAES surgeons who perform endocrine operations are otolaryngologists (24.5%) and other general surgeons (18.5%). Overall, non-AAES surgeons perform the majority of endocrine operations at academic institutions (61.6%), and low-volume surgeons perform most of these operations (55.6%).
Research has shown that high-volume surgeons have improved outcomes. Even in academia, however, the majority of endocrine operations are performed by low-volume surgeons, suggesting that there is an opportunity for expanding the number of surgeons with expertise in endocrine surgery in present-day academic centers.
内分泌外科是一个不断发展的专业领域。在本研究中，我们试图描绘当今学术中心负责治疗内分泌疾病的外科医生的实践模式。
对2005年、2009年和2013年的教职员工实践解决方案中心数据库进行了回顾。实践模式由国际疾病分类第九版和当前手术操作术语代码确定，并分析了实践构成、区域差异和内分泌手术量。
在97个全国性学术中心中，有52个中心在研究中有120名执业的美国内分泌外科医生协会（AAES）外科医生。平均而言，内分泌手术约占AAES外科医生实践的65%，51%的外科医生被认为是甲状腺切除术、甲状旁腺切除术和肾上腺切除术的高手术量医生。大多数进行内分泌手术的非AAES外科医生是耳鼻喉科医生（24.5%）和其他普通外科医生（18.5%）。总体而言，非AAES外科医生在学术机构中进行了大部分内分泌手术（61.6%），低手术量医生进行了这些手术的大部分（55.6%）。
研究表明，高手术量医生的治疗效果有所改善。然而，即使在学术界，大多数内分泌手术也是由低手术量医生进行的，这表明在当今学术中心有机会增加具有内分泌外科专业知识的外科医生数量。
