Outcomes of outpatient thyroidectomy for high-risk patients: A single-site retrospective cohort study

While outpatient thyroidectomy is well-studied in healthy patients, data are limited in patients with previously defined relative contraindications including obstructive sleep apnea, anticoagulant or antiplatelet use, substernal goiter, and Graves' disease. This study evaluates safety of outpatient thyroidectomy in high-risk patients compared to low-risk patients at a high-volume endocrine surgery center.

Retrospective cohort.

From 2021 to 2025, 513 patients underwent outpatient total thyroidectomy (271 low-risk; 242 high-risk). Complication rates were low and comparable between groups. Hematoma occurred in 1.1% of low-risk versus 0.4% of high-risk patients (p = 0.70). Anticoagulant or antiplatelet therapy (excluding aspirin) was held preoperatively. Transient recurrent laryngeal nerve injury was 4.06% vs 4.56% (p = 0.95); transient hypocalcemia was 15.13% vs 16.6% (p = 0.74). No permanent nerve injuries or permanent hypocalcemia occurred. Adverse 30-day events were also comparable.

Outpatient thyroidectomy is safe in patients with some relative contraindications. These findings support expanding outpatient eligibility criteria for high-volume centers.