How to perform a thyroidectomy in an outpatient setting

Area of Science:

• Endocrinology
• Surgical Oncology
• Ambulatory Surgery

Background:

• Current French practice for thyroidectomy involves inpatient care.
• No prior series on outpatient thyroidectomy have been reported in France.

Purpose of the Study:

• To evaluate the acceptability, feasibility, and safety of outpatient unilateral thyroid lobectomy.
• To assess the viability of ambulatory thyroid surgery in a university hospital setting.

Main Methods:

• Patients with thyroid nodules meeting inclusion criteria were offered outpatient unilateral thyroid lobectomy.
• Surgical protocol excluded drainage and dressings; standard anesthetic, analgesic, and antiemetic protocols were used.
• Evaluation focused on unplanned admissions, complications, and re-operation rates.

Main Results:

• Out of 153 unilateral thyroid lobectomies, 95 (62%) were planned for outpatient surgery, increasing from 36% to 90% over 8 years.
• Seventy-seven patients were discharged 6-8 hours post-operation; no patients were readmitted.
• One patient required re-operation for hemorrhage and was discharged the next day; 13.7% were admitted due to nausea or discomfort.

Conclusions:

• Outpatient unilateral thyroid lobectomy is feasible and safe with proper facilities and protocols.
• Effective management of postoperative nausea and preoperative patient education are crucial for success.
• Ambulatory thyroid surgery can be a safe alternative to inpatient care.