NDLI: Chirurgische Begutachtung von Komplikationen nach Schilddrüsenoperationen.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Dralle, H.
Spatial Coverage	Germany
Description	Author Affiliation: Dralle H ( Universitätsklinik für Allgemein-, Viszeral- und Gefäßchirurgie, Medizinische Fakultät, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 40, 06097, Halle (Saale), Deutschland, henning.dralle@uk-halle.de.)
Abstract	BACKGROUND: The extent, magnitude and technical equipment used for thyroid surgery has changed considerably in Germany during the last decade. The number of thyroidectomies due to benign goiter have decreased while the extent of thyroidectomy, nowadays preferentially total thyroidectomy, has increased. Due to an increased awareness of surgical complications the number of malpractice claims is increasing. OBJECTIVES: In contrast to surgical databases the frequency of complications in malpractice claims reflects the individual impact of complications on the quality of life. In contrast to surgical databases unilateral and bilateral vocal fold palsy are therefore at the forefront of malpractice claims. As guidelines are often not applicable for the individual surgical expert review, the question arises which are the relevant criteria for the professional expert witness assessing the severity of the individual complication. RESULTS: While in surgical databases major complications after thyroidectomy, such as vocal fold palsy, hypoparathyroidism, hemorrhage and infections are equally frequent (1-3 %), in malpractice claims vocal fold palsy is significantly more frequent (50 %) compared to hypoparathyroidism (15 %), hemorrhage and infections (about 5 % each). To avoid bilateral nerve palsy intraoperative nerve monitoring has become of utmost importance for surgical strategy and malpractice suits alike. For surgical expert review documentation of individual risk-oriented indications, the surgical approach and postoperative management are highly important. CONCLUSION: Guidelines only define the treatment corridors of good clinical practice. Surgical expert reviews in malpractice suits concerning quality of care and causality between surgical management, complications and sequelae of complications are therefore highly dependent on the grounds and documentation of risk-oriented indications for thyroidectomy, intraoperative and postoperative surgical management.
File Format	HTM / HTML
ISSN	00094722
Issue Number	1
Volume Number	86
e-ISSN	14330385
Journal	Der Chirurg
Language	German
Publisher	Springer
Publisher Date	2015-01-01
Publisher Place	Germany
Access Restriction	Subscribed
Subject Keyword	Discipline General Surgery Expert Testimony Legislation & Jurisprudence Malpractice Postoperative Complications Diagnosis Thyroidectomy Adverse Effects Cross-sectional Studies Germany Humans Hypoparathyroidism Epidemiology Postoperative Hemorrhage Quality Of Life Surgical Wound Infection Vocal Cord Paralysis English Abstract Journal Article Review
Alternative Title	Surgical assessment of complications after thyroid gland operations
Content Type	Text
Resource Type	Article
Subject	Surgery

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