Outpatient endocrine surgery practice patterns are highly variable among US endocrine surgery fellowship programs.

Area of Science:

• Surgical Innovation
• Endocrine Surgery
• Patient Outcomes

Background:

• Outpatient endocrine surgery is recognized as safe.
• Current guidelines lack specific postoperative protocols for same-day discharge.
• Variability in practice exists among endocrine surgery programs.

Purpose of the Study:

• To investigate the uniformity of same-day discharge practices in endocrine surgery training programs.
• To identify factors influencing same-day discharge decisions.
• To compare programs with low versus high same-day discharge rates.

Main Methods:

• An internet-based survey was distributed to endocrine surgery fellows in accredited programs.
• Programs were categorized based on their same-day discharge rates (≤2% vs. ≥2%).
• Survey data analyzed expert input on postoperative protocols and discharge criteria.

Main Results:

• A significant bimodal distribution in same-day discharge rates was observed across 20 institutions.
• Nine programs had ≤2% same-day discharge, while seven had ≥90%.
• Postoperative observation periods, geographic restrictions, and influencing factors (e.g., anticoagulation, neck dissection) varied inconsistently.

Conclusions:

• Same-day discharge practices in endocrine surgery are non-uniform and largely dictated by surgeon preference.
• Factors influencing discharge decisions differ significantly between programs.
• Standardized protocols for outpatient endocrine surgery discharge are needed.