Parathyroidectomy for primary hyperparathyroidism: early discharge

With increasing awareness of cost-containment measures, early discharge after parathyroidectomy for primary hyperparathyroidism is to be evaluated. This report concerns the Cleveland Clinic experience with the last 70 consecutive patients treated for primary hyperparathyroidism from June 1981 to June 1983. The mean postoperative hospital stay was 1.4 days. Most patients were discharged on the morning of the second postoperative day receiving oral calcium supplements for 3 weeks. Three patients were discharged on the morning of the first postoperative day. The overall mortality rate was 0%. Morbidity included two patients (2.9%) who developed symptoms of mild tetany after discharge that responded to an increased dose of oral calcium. The usual practice of most surgeons of delaying hospital discharge after neck exploration for primary hyperparathyroidism for 5 to 7 days in fear of symptomatic hypocalcemia is unnecessary. Considerable cost containment can be achieved by sparing patients from 3 to 5 extra days of hospitalization.