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Feasibility criteria for total thyroidectomy in outpatient surgery
Jean-Baptiste Philippe1, Jérémie Riou2, Annabelle Lemoult1
1Service de chirurgie viscérale et endocrinienne, CHU Angers, 49933 Angers cedex 9, France.
Annales D'Endocrinologie
|August 12, 2019
Summary
Extended surgery time, female gender, and benign adenoma indicate higher risks for total thyroidectomy (TT) complications. These factors are crucial for selecting patients for outpatient TT procedures.
Area of Science:
- Endocrinology
- Surgical Oncology
- Health Services Research
Background:
- France aims to reduce healthcare costs through policies favoring outpatient procedures.
- Total thyroidectomy (TT) is a potential candidate for outpatient management.
- Careful patient selection is essential to minimize risks associated with outpatient TT.
Purpose of the Study:
- To identify risk factors for postoperative complications following total thyroidectomy (TT).
- To inform patient selection for outpatient thyroid surgery.
- To assess the feasibility of reducing healthcare costs through ambulatory TT.
Main Methods:
- A single-center observational study conducted between January 2010 and December 2015.
- Analysis of correlations between patient/surgical factors and postoperative complications in 424 TT procedures.
- Complications assessed included hypocalcemia, recurrent laryngeal nerve lesions, and compressive hematoma.
Main Results:
- Overall morbidity was 24.06%, with hypocalcemia (20.04%), nerve lesions (4.25%), and hematoma (0.94%) being the primary complications.
- Risk factors for hypocalcemia included female gender, longer surgery time, and benign adenoma indication.
- Repeated dissection was a significant risk factor for compressive hematoma requiring re-operation.
Conclusions:
- Surgery time, female gender, repeated dissection, and benign adenoma indication are key risk factors for TT complications.
- These identified risk factors should guide the decision-making process for outpatient total thyroidectomy.
- Optimizing patient selection can enhance the safety and efficacy of outpatient TT procedures.
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