Determinants of operative time in thyroid surgery: A prospective multicenter study of 3454 thyroidectomies

• DOI: 10.1371/journal.pone.0181424
• Publication Date: 2017-07-27T17:55:47Z
• Authors: Arnaud Patoir; Cécile Payet; Jean-Louis Peix; Cyrille Colin; Léa Pascal; Jean-Louis Kraimps; Fabrice Menegaux; François Pattou; Frédéric Sebag; Sandrine Touzet; Stéphanie Bourdy; Jean-Christophe L...; Antoine Duclos
• Keywords: Staffing

Objective To identify the determinants of operative time for thyroidectomy and quantify relative influence preoperative intra-operative factors. Background Anticipation is key to avoid both waste hospital resources dissatisfaction surgical staff. Having an accurate anticipated planning would allow a rationalized operating room use may improve patient flow staffing level. Methods We conducted prospective, cross-sectional study between April 2008 December 2009. The 3454 patients who underwent performed by 28 surgeons in five academic hospitals was monitored. used multilevel linear regression model while accounting interplay characteristics specific surgeons, patients, procedures. impact each variable on estimated. Results Overall, 86% (99% CI 83 89) variation related variables. Surgeon accounted 32% 29 35) variation, center location 29% 25 33), procedure or variables 24% 20 27). Operative significantly lower among experienced having practiced from 5–19 years (-21.8 min, P<0.05), performing at least 300 thyroidectomies per year (-28.8 with increasing number same day (-11.7min, P<0.001). Conversely, increased cases supervision more surgeon (+20.0 remaining 13.0% variability attributable unanticipated technical difficulties surgery. Conclusions Variation duration largely explained factors, suggesting that it can be accurately anticipated. Prediction tools allowing better regulation rooms appears feasible working conditions cost management.