Questionable safety of thyroid surgery with same day discharge

Area of Science:

• Endocrine Surgery
• Surgical Outcomes
• Patient Safety

Background:

• Increasing trend of outpatient surgical procedures.
• National Health Service target for day case surgeries.
• Thyroidectomy inclusion in day case procedures with limited adoption for same-day discharge.

Purpose of the Study:

• To review the evidence base for same-day discharge thyroid surgery.
• To inform a consensus position for the British Association of Endocrine and Thyroid Surgeons.

Main Methods:

• Systematic review of English medical literature via MEDLINE®.
• Collation and review of relevant articles.
• Commissioned by the British Association of Endocrine and Thyroid Surgeons.

Main Results:

• Limited comparative data available for day case thyroid surgery.
• Feasible and potentially cost-saving for hospitals.
• Significant risk of life-threatening post-operative bleeding, with an estimated 50% occurring outside the hospital if discharged within six hours.

Conclusions:

• Same-day discharge for thyroidectomy in the UK is not supported.
• Potential financial benefits are outweighed by increased patient risk.
• Recommendation for 23-hour observation surgery to enhance patient safety.