['Same-day' thyroid surgery. Results after 805 thyroidectomies in a fast-track program]

The aim of this study was to analyze the validity of a fast-track surgery program with less than 24-hour admission for all thyroid disease treated in an endocrine surgery unit.

Between January 2000 and January 2006, 805 consecutive patients underwent thyroid surgery in a fast-track program. Data on type of disease, procedure, operating time, length of hospital stay, postoperative morbidity, and the number of reinterventions and readmissions were gathered.

After a minimum follow-up of 6 months, transitory hypocalcemia occurred in 4.8%, permanent hypocalcemia in 0.2%, transitory dysphonia in 2.5%, and permanent dysphonia in 1.1%. Only 7 patients required emergency reintervention in the first 6 hours after surgery, in all patients due to hemorrhage. Most of these complications occurred in patients undergoing surgery for hyperthyroidism or in those undergoing total thyroidectomy with modified radical neck dissection. Most patients were discharged within 24 hours with a mean length of hospital stay of 23.9 hours, excluding patients who underwent cervical lymphadenectomy. There were only three readmissions, all of which were due to correction of symptomatic hypocalcemia.

Except for total thyroidectomy with modified radical neck dissection due to cancer, all thyroid surgery can be performed in a fast-track program with less than 24-hour admission, within a specialized endocrine surgery unit.