Outpatient hemithyroidectomy for benign thyroid disease.

Area of Science:

• Endocrinology
• Surgical Oncology
• General Surgery

Background:

• Hemithyroidectomy for benign thyroid disease traditionally requires inpatient care due to bleeding risks.
• Outpatient hemithyroidectomy has not been widely evaluated, particularly in a Danish healthcare setting.
• Previous concerns focused on post-thyroidectomy bleeding (PTB) as a primary complication.

Purpose of the Study:

• To evaluate the safety and feasibility of outpatient hemithyroidectomy compared to inpatient procedures.
• To assess specific complications such as post-thyroidectomy bleeding (PTB), nerve injury, and infection.
• To determine suitability for a selected patient group with specific health criteria.

Main Methods:

• A retrospective cohort study of hemithyroidectomy patients at a Danish regional hospital (June 2014 - June 2019).
• Inclusion criteria: no malignancy suspicion, lobe < 100 ml, ASA class I/II, no anticoagulation.
• Primary outcome: post-thyroidectomy bleeding (PTB); secondary outcomes: nerve injury, infection, reintervention, unplanned contacts.

Main Results:

• 229 hemithyroidectomies performed; 137 planned as outpatient, with 91% successfully completed.
• No instances of post-thyroidectomy bleeding (PTB) occurred in either outpatient or inpatient groups.
• Outpatient group reported 1.5% permanent recurrent nerve injury and 0.7% superficial wound infection.

Conclusions:

• Hemithyroidectomy for benign thyroid disease can be safely performed in an outpatient setting for carefully selected patients.
• The outpatient approach demonstrates comparable safety to inpatient procedures regarding major complications like bleeding.
• This study supports the expansion of outpatient hemithyroidectomy in the Danish healthcare system for appropriate candidates.