Analysis of safety of short-stay thyroid surgery

The duration of hospital stay, following surgical procedures, has undergone a significant reduction in recent years. However, there are some risks associated with short-stay thyroid surgery. An analysis has been made of data from patients who underwent short-stay thyroid surgery, analyzing the complications associated with this procedure. Overall 270 consecutive patients undergoing thyroidectomy in 2007 and 2008 were prospectively analyzed. Post-operative care included routine ward overnight observation. The discharge criteria were: stable vital signs; apyretic; no wound or airway problems; tolerating diet; and established autonomy at discharge. Data were collected regarding patients' discharge criteria status, length of hospital stay and readmission, as well as morbidity (post-operative haemorrhage, recurrent laryngeal nerve injury and hypocalcaemia) and mortality. This series comprised 175 total thyroidectomies, 93 hemi-thyroidectomies and 2 isthmusectomies. No cases of death or post-operative haemorrhage occurred in any of these patients. Permanent unilateral recurrent laryngeal nerve injury was observed in 4 patients (1.48%). Transient post-operative hypocalcaemia occurred in 23 patients, whereas permanent post-operative hypocalcaemia was observed in 8 patients (2.96%); 4 patients were re-admitted and required early calcium supplementation. Five patients failed to tolerate the diet during the immediate post-operative period. The average duration of hospital stay was 1.02 days. Considering the 4 patients who required re-admission due to hypocalcaemia, the total length of hospital stay was 1.05 days. In conclusion, the one-day surgery model is safe and effective in patients undergoing surgery for thyroid disorders.