To examine whether gender and experience treaning of the surgeon is associated with outcomes among patients undergoing thyroid surgeries

This cohort study evaluated all patients operated for total thyroidectomy (TT) in a high-volume endocrine surgery center between 2007 and 2022. Postoperative adverse outcomes were defined as any surgical complications after TT: hypocalcemia, neck hematoma or recurrent laryngeal nerve (RLN) paralysis. Hypocalcemia was considered permanent if the plasma parathyroid hormone levels six months postoperatively were less than 15 pg/mL, and the patient continued to require supplementation. RLN paralysis was considered permanent if there was no proof of recovery using laryngoscopy within six months of the operation. Junior surgeons were defined as qualified doctors in clinical training during the 4 first years. Others (general practionner, academic doctors) were senior surgeons.

25.008 patients were included (12.205 operated by male surgeon and 12.803 by female surgeon). The prevalence of postoperative complications was higher for male surgeons (2.093; 17%) than for female surgeons (1.721; 14%) (p<0.0001). Senior female surgeons have the lowest risk of postoperative complications (691/5.989; 11.5%) compared to others (junior female surgeons (1.030/6.814; 15.1% (junior male surgeons (892/5.187; 17.2%), senior male surgeons (1.201/7.014; 17.1%),) (p<0.001)). After adjusting for surgical procedure (complexity; cancer staging); the risks of permanent hypocalcemia and RLN paralysis were higher among patients treated by male than female surgeons (13.3%vs9.8%; OR=1.09 and 3.3%vs2.9%; OR=1.06 respectively).

After adjusting for surgical procedure, the findings of this study suggest that patients treated by senior female surgeons have lower rates of adverse postoperative outcomes in thyroid surgery.