INTRODUCTION AND GUIDE TO USING THIS WEBSITE
Welcome to the BAETS Surgeon-Specific Outcomes website.
This site provides data on the outcomes of thyroid surgery performed by BAETS members in the UK between 1st of July 2012 and June 2016, and is an update of the results published last year as part of NHS England's initiative to publish surgical outcome data from a variety of national audits.Data were extracted from the BAETS database on 24th of April 2019.
Summary of Main Findings
Overall, outcomes are similar to those reported last year.
Mortality of thyroid surgery remains, reassuringly, extremely low, less than 0.1%, with no surgeons reporting a mortality rate greater than that expected by chance. The circumstances of all reported deaths were also examined, and in no case was death directly related to any surgical complications.
Early re-operation to control bleeding in the neck is approximately 1%.
Hospital stay after thyroid surgery is short. After lobectomy, most patients are discharged within 24 hours; after total thyroidectomy, most require only 1-3 days in hospital. Following discharge home, only around 2% require re-admission for reasons related to their surgery.
Late hypocalcaemia (low levels of calcium in the blood) after total thyroidectomy is the commonest reported complication, at about 6.5%, with much greater variation between surgeons than with other outcomes.
Levels of missing data on the main outcome measures are marginally better than in 2014, at 11.4% on average.
BACKGROUND:
The BAETS Audit
The British Association of Endocrine and Thyroid Surgeons is a group of UK surgeons with a specialist interest in surgery of the endocrine organs (predominantly the thyroid, parathyroid and adrenal glands).
Since 2004, the BAETS has operated a national audit of its members' surgical procedures, via an electronic submission format, in conjunction with Dendrite Clinical Systems Ltd., with the aim of documenting certain complications of endocrine surgery. Access to the audit is restricted to full members of the BAETS, with data being entered by the individual member.
Outcomes for thyroidectomy were published at individual surgeon level, for the first time in July 2013, as part of NHS England's national audit initiative, were updated in October 2014 and again in the current publication.
Thyroidectomy
The thyroid gland is located in the neck, and is responsible for producing thyroxine, a hormone involved in the control of the body's metabolism. It is made up of two halves or 'lobes', which lie either side of the trachea (windpipe), joined together by a narrow 'isthmus'.
Removal of all or part of the thyroid may be necessary: to treat thyroid over-activity , to relieve symptoms from enlargement of the thyroid (referred to as 'goitre'), to provide a diagnosis for a lump in the thyroid , or to treat some types of thyroid cancer.
Surgery usually involves removal of either one or other lobe ('Lobectomy'), the whole thyroid ('Total Thyroidectomy') or the isthmus alone ('Isthmusectomy').
In modern surgical practice, thyroid surgery is very safe, with an extremely low mortality rate. Complications may, however, occur due to injury to delicate surrounding structures, and include:
- Bleeding in the neck after surgery, which may require re-operation to prevent obstruction of the patient's airway.
- Low calcium levels in the blood ('Hypocalcaemia'), due to damage of the parathyroid glands, which regulate calcium levels and which lie very close to the thyroid. Hypocalcaemia may recover spontaneously, or be permanent.
- Changes in the voice, due to injury of the recurrent laryngeal nerves, which control the movement of the vocal cords in the larynx (voicebox). These may recover spontaneously, or rarely be permanent.