OBJECTIVE: To establish whether outpatient thyroid surgery is safe. DESIGN: Prospective, observational cohort. SETTING: Two tertiary care centres. METHODS: Although there is currently a trend toward ambulatory surgery in many domains, thyroidectomy has traditionally remained an inpatient procedure. We present our 200-case experience of total and partial thyroidectomy in an outpatient setting. Consecutive patients were prospectively recruited between May 2009 and October 2010. Surgeries were performed by four surgeons. A postoperative parathyroid hormone (PTH) level was obtained in the recovery room and used to guide the prescription of calcium and calcitriol oral supplements according to our institutional protocol. MAIN OUTCOME MEASURES: Postoperative complications, admission and readmission rates, patients' satisfaction, and feeling of security on a 10-point scale. RESULTS: A total of 171 patients, for a total of 200 surgical procedures: 100 hemithyroidectomies, 34 completion hemithyroidectomies, and 66 total thyroidectomies (including 14 with central compartment dissection). Immediate admission was decided in 12% of cases due to peroperative findings (15 patients), anesthetic considerations (7 patients), bilateral vocal fold paralysis noted in the recovery room (1 patient), and surgery late in the afternoon (1 patient). Two patients were readmitted for surgical site infections and one due to hypocalcemia. Temporary symptomatic hypocalcemia or decreased PTH level occurred in 10% (20 patients). On average, patients' satisfaction and feeling of security reached 9.3 on a 10-point scale. CONCLUSION: Outpatient thyroid surgery is a safe and desirable option.
OBJECTIVE: To establish whether outpatient thyroid surgery is safe. DESIGN: Prospective, observational cohort. SETTING: Two tertiary care centres. METHODS: Although there is currently a trend toward ambulatory surgery in many domains, thyroidectomy has traditionally remained an inpatient procedure. We present our 200-case experience of total and partial thyroidectomy in an outpatient setting. Consecutive patients were prospectively recruited between May 2009 and October 2010. Surgeries were performed by four surgeons. A postoperative parathyroid hormone (PTH) level was obtained in the recovery room and used to guide the prescription of calcium and calcitriol oral supplements according to our institutional protocol. MAIN OUTCOME MEASURES: Postoperative complications, admission and readmission rates, patients' satisfaction, and feeling of security on a 10-point scale. RESULTS: A total of 171 patients, for a total of 200 surgical procedures: 100 hemithyroidectomies, 34 completion hemithyroidectomies, and 66 total thyroidectomies (including 14 with central compartment dissection). Immediate admission was decided in 12% of cases due to peroperative findings (15 patients), anesthetic considerations (7 patients), bilateral vocal fold paralysis noted in the recovery room (1 patient), and surgery late in the afternoon (1 patient). Two patients were readmitted for surgical site infections and one due to hypocalcemia. Temporary symptomatic hypocalcemia or decreased PTH level occurred in 10% (20 patients). On average, patients' satisfaction and feeling of security reached 9.3 on a 10-point scale. CONCLUSION:Outpatient thyroid surgery is a safe and desirable option.
Authors: Justine Philteos; Elif Baran; Christopher W Noel; Jesse D Pasternak; Kevin M Higgins; Jeremy L Freeman; Albino Chiodo; Antoine Eskander Journal: Front Endocrinol (Lausanne) Date: 2021-07-28 Impact factor: 5.555