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Outpatient hemithyroidectomy
C Lacroix1, G Potard2, C Clodic2
1Service d'ORL et de chirurgie cervico-faciale, hôpital Morvan, CHRU, 2, avenue Foch, 29200 Brest, France; EA 4685 Laboratoire de Neurosciences, Faculté de Médecine, Université de Brest, 5, avenue Foch, 29609 Brest cedex, France.
Insights
Outpatient hemithyroidectomy is feasible, safe, and cost-effective. Patients reported high satisfaction, with no increased risks and significant cost savings for the hospital.
Area of Science:
- Surgical Oncology
- Endocrine Surgery
- Health Services Research
Background:
- Outpatient surgery, or day-only admission, is increasingly adopted due to societal shifts and cost-reduction goals.
- Hemithyroidectomy is a common surgical procedure with established complication profiles.
- Assessing the viability of outpatient hemithyroidectomy is crucial for optimizing surgical care delivery.
Purpose of the Study:
- To evaluate the feasibility of performing hemithyroidectomy as an outpatient procedure.
- To assess patient satisfaction with outpatient hemithyroidectomy.
- To determine the cost-effectiveness of outpatient hemithyroidectomy.
Main Methods:
- A retrospective analysis of 146 hemithyroidectomies performed between August 2011 and September 2012.
- Inclusion/exclusion criteria were based on surgical, anesthetic, patient, and risk factors.
- Standardized protocols for preoperative information, anesthesia, surgery, and postoperative care were implemented. Patient satisfaction was assessed via questionnaire, and cost analysis was performed.
Main Results:
- Out of 40 eligible patients, 32 underwent outpatient hemithyroidectomy.
- Two cases required conversion to inpatient stay due to medication and postoperative nausea.
- One patient was hospitalized overnight due to severe asthenia and nausea.
Conclusions:
- Outpatient hemithyroidectomy demonstrates high patient satisfaction, with 100% willing to repeat the experience.
- The procedure resulted in a mean cost saving of €711 per patient for the institution.
- Outpatient hemithyroidectomy enhances patient comfort without compromising safety and reduces healthcare management costs.
Unlabelled:
Outpatient surgery consists of performing an elective surgical procedure in the context of a day-only admission. This type of management is the result of sociological changes and allows a reduction of the cost. Hemithyroidectomy is a well-defined surgical procedure with known complications. The authors assessed the feasibility, patient satisfaction and cost of outpatient hemithyroidectomy.
Material And Methods:
One hundred and forty-six hemithyroidectomies were performed between August 2011 and September 2012. Inclusion criteria for outpatient surgery were surgical, anaesthetic and patient-dependent. Exclusion criteria were related to the bleeding risk, socio-economic conditions and the patient's understanding of the procedure. Preoperative information and the modalities of anaesthesia, surgery, postoperative surveillance and follow-up were standardized. Patient satisfaction was evaluated by questionnaire and cost was evaluated on the basis of medical information department data.
Results:
Forty patients were eligible and 34 patients agreed to outpatient surgery (M/F sex ratio: 1/4; mean age: 46 ± 6.3 years), but only 32 operations were performed on an outpatient basis. Two conversions to conventional hospitalisation were required, one because of preoperative initiation of platelet anti-aggregants and the other because of nausea. One patient remained in hospital on the day after the operation because of severe asthenia and nausea.
Conclusion:
Patients were satisfied with this type of management and 100% of them reported that they would repeat the experience. The economy for our establishment was €711 per patient. This procedure improves patient comfort without increasing the risks and allows a reduction of management costs.
