Abstract：
OBJECTIVES:Outpatient thyroid surgery is becoming increasingly common. The aim of this study was to clarify the principles for safe outpatient thyroid surgery and review our outcomes with the use of a protocol for outpatient thyroidectomy in a large patient cohort. STUDY DESIGN:A systematic analysis of a prospectively maintained database of outcomes of thyroidectomy in a tertiary endocrine surgery practice. SETTING:Academic medical center. SUBJECTS AND METHODS:A protocol for outpatient thyroidectomy was conceived and refined over 3 years. A prospective analysis of all thyroidectomies accomplished by a single surgeon who used this protocol from May 2006 to November 2013 was then undertaken. Patient demographics, operative and pathologic data, admission status, complications, and readmission rates were recorded. RESULTS:A total of 1,311 thyroidectomy procedures were performed during the study period, of which 1,026 (78.3 %) were conducted on an outpatient basis. The readmission rate for outpatients was 0.9%, with only 1 readmission in the last 200 procedures. Inpatients (which included patients in the 23-hour "observation" category) were readmitted more often than outpatients (3.5% vs 0.9%, P < .01). Outpatient management increased steadily throughout the study period (from 59.7% to 92.3%, P < .01), despite a larger mean nodule size and a greater rate of malignancy over time. There were no changes in the complication rate across the study timeframe except for the incidence of temporary hypocalcemia, which decreased over time (P < .01). CONCLUSION:Outpatient thyroid surgery is safe in appropriately selected patients using an optimized and systematic protocol.
journal_name
Surgeryjournal_title
Surgeryauthors
Segel JM,Duke WS,White JR,Waller JL,Terris DJdoi
10.1016/j.surg.2015.08.007subject
Has Abstractpub_date
2016-02-01 00:00:00pages
518-23issue
2eissn
0039-6060issn
1532-7361pii
S0039-6060(15)00626-1journal_volume
159pub_type
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