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Outpatient and short-stay thyroid surgery
P Lo Gerfo1, R Gates, P Gazetas
1Department of Surgery, Columbia University, Columbia Presbyterian Medical Center, New York, New York 10032.
Head & Neck
|March 1, 1991
Summary
Ambulatory surgery for thyroid procedures is safe and effective for select patients. Thyroid lobectomies and subtotal thyroidectomies can be performed with low complication rates in an outpatient setting.
Area of Science:
- Endocrinology
- Surgical Oncology
- Ambulatory Surgery
Background:
- Thyroid procedures traditionally involved inpatient stays.
- Simple thyroid surgeries demonstrate low complication rates.
- Patient recovery in the recovery room suggests potential for outpatient procedures.
Purpose of the Study:
- To evaluate the safety and efficacy of performing thyroid procedures in an ambulatory surgery setting.
- To determine complication rates and length of stay for outpatient thyroidectomies.
- To assess the feasibility of same-day discharge for select thyroid surgery patients.
Main Methods:
- Retrospective review of 134 consecutive thyroid procedures (July 1987-July 1989).
- Exclusion of complex cases (reoperations, neck dissections, etc.).
- Analysis of patient demographics, diagnoses, procedures, anesthesia types, and outcomes.
Main Results:
- 76 out of 134 patients (57%) were discharged the same day of surgery.
- Average length of stay was 0.49 days.
- Complications included transient hypocalcemia (6%) and permanent recurrent laryngeal nerve paralysis (0.75%), both in total thyroidectomy patients. No reoperations or readmissions were required.
Conclusions:
- Thyroid lobectomies and subtotal thyroidectomies can be safely performed in an ambulatory surgery setting.
- Specific patient selection criteria are crucial for successful outpatient thyroid surgery.
- Outpatient thyroid surgery does not increase morbidity or mortality for appropriately selected patients.