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Updated: Nov 18, 2025
Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Safety and cost-effectiveness of outpatient thyroidectomy: A retrospective observational study
Mohammed AlEssa1, Samiah S Al-Angari1, Mohammed Jomah1
1From the Department of Otolaryngology - Head & Neck Surgery (AlEssa, Al-Angari, Jomah, Al-Dhahri), College of Medicine; from the Division of Endocrinology and Metabolism, Department of Medicine (Mujammami), King Saud University; from the Department of Otolaryngology - Head & Neck Surgery (AlEssa), King Abdulaziz Medical City, National Guard Health Affairs; from the Division of Otolaryngology - Head & Neck Surgery, Department of Surgery (AlOqaili), King Abdullah bin Abdulaziz University Hospital; from the Department of Otolaryngology - Head & Neck Surgery (Al-Dhahri), King Fahad Medical City, Riyadh; and from the Department of Otolaryngology - Head & Neck Surgery (Al-Hakami), College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Kingdom of Saudi Arabia.
Objectives:
To investigate the safety and cost-effectiveness of outpatient thyroidectomy and provide a systematic postoperative protocol for safe discharge.
Methods:
In this retrospective review, the medical records of all patients who underwent total, hemi, or completion thyroidectomy from July 2017 to April 2019 at 2 tertiary care hospitals were reviewed. Multivariable analysis was performed on the potential predictors of postoperative complications. Healthcare costs were calculated by the type of admission based on the average costs at the 2 centers.
Results:
One hundred twenty-two patients were enrolled in this study. The majority of cases were in the outpatient group (n=76, 62.3%). Total thyroidectomy was the most prevalent type of surgery (n=90, 73.7%). There were a total of 20 complications in 18 patients (inpatient=9 versus [vs.] outpatient=9). No cases of cervical hematoma or bilateral vocal cord paralysis were encountered. No significant difference was found between the type of admission (outpatient vs. inpatient) and postsurgical complications (p=0.24). The multivariable regression model retained significance for male gender and American Society of Anesthesiologists Classification III as potential predictors of postoperative complications. Healthcare costs would be reduced by at least 15.5% with the implementation of outpatient surgery.
Conclusion:
Outpatient thyroidectomy is as safe as inpatient thyroidectomy given the proper selection of cases. We project cost containment of over $711 thousand per 1,000 cases for outpatient thyroid surgeries.
