Ambulatory thyroidectomy is safe and beneficial in papillary thyroid carcinoma: Randomized controlled trial

Zhang, Zeyu; Xia, Fada; Wang, Wenlong; Jiang, Bo; Yao, Lei; Huang, Yun; Li, Xinying

doi:10.1002/hed.26557

Cited by 8 publications

(12 citation statements)

References 19 publications

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“…Meantime, the present study also showed significant economic benefits and a shorter duration of hospitalization in ambulatory ETCBA, which was solid but not surprising because the ambulatory management was administrated to achieve these purposes. Additionally, multiple studies on ambulatory surgery reported similar patient benefits (7,(13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 85%

“…Furthermore, the mental health of patients was also investigated within one month, using the Depression Anxiety Stress Scales-21 (DASS-21), a screening tool to measure three comorbid depression, anxiety and stress disorders (Supplement Table 1) (7).…”

Section: Outcomes and Follow-upmentioning

confidence: 99%

“…Ambulatory surgery has become more and more common in recent years, offering various advantages (7). At present, ambulatory open thyroidectomy is adopted by multiple medical centers, showing no difference in readmissions and complications compared with conventional thyroidectomy (8).…”

Section: Introductionmentioning

confidence: 99%

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Ambulatory Endoscopic Thyroidectomy via a Chest-Breast Approach Has an Acceptable Safety Profile for Thyroid Nodule

Zhang

Xia

2021

Front. Endocrinol.

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IntroductionWith the growing esthetic requirements, endoscopic thyroidectomy develops rapidly and is widely accepted by practitioners and patients to avoid the neck scar caused by open thyroidectomy. Although ambulatory open thyroidectomy is adopted by multiple medical centers, the safety and potential of ambulatory endoscopic thyroidectomy via a chest-breast approach (ETCBA) is poorly investigated.Material and MethodsPatients with thyroid nodules who received conventional or ambulatory ETCBA at Xiangya hospital, Central South University from January 2017 to June 2020 were retrospectively included. The incidence of postoperative complications, 30-days readmission rate, financial cost, duration of hospitalization, mental health were mainly investigated.ResultsA total of 260 patients were included with 206 (79.2%) suffering from thyroid carcinoma, while 159 of 260 received ambulatory ETCBA. There was no statistically significant difference in the incidence of postoperative complications (P=0.249) or 30-days readmission rate (P=1.000). In addition, The mean economic cost of the ambulatory group had a 29.5% reduction compared with the conventional group (P<0.001). Meanwhile, the duration of hospitalization of the ambulatory group was also significantly shorter than the conventional group (P<0.001). Patients received ambulatory ETCBA showed a higher level of anxiety (P=0.041) and stress (P=0.016). Subgroup analyses showed consistent results among patients with thyroid cancer with a 12.9% higher complication incidence than the conventional ETCBA (P=0.068).ConclusionAmbulatory ETCBA is as safe as conventional ETCBA for selective patients with thyroid nodules or thyroid cancer, however with significant economic benefits and shorter duration of hospitalization. Extra attention should be paid to manage the anxiety and stress of patients who received ambulatory ETCBA.

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Section: Discussionmentioning

confidence: 85%

Section: Outcomes and Follow-upmentioning

confidence: 99%

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Ambulatory Endoscopic Thyroidectomy via a Chest-Breast Approach Has an Acceptable Safety Profile for Thyroid Nodule

Zhang

Xia

2021

Front. Endocrinol.

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“…Randomised controlled trials and large multicentre studies (e.g., population-based studies) are required to ensure the best evidence supports these results. Zhang et al [ 50 ] recently published an RCT on outpatient total and hemithyroidectomy reporting that outpatient thyroidectomy is safe in patients with papillary thyroid carcinoma. This RCT was not relevant in this review as the outpatient setting described was discharge before 23 h. Completing an RCT that examines the risk of PTB in a selected outpatient population is challenging as the PTB outcome is so rare.…”

Section: Discussionmentioning

confidence: 99%

Risk of hematoma after hemithyroidectomy in an outpatient setting: a systematic review and meta-analysis

Jeppesen

Moos

Holm

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose After thyroid surgery, the overriding concern is the risk of post-thyroid bleeding (PTB). This systematic review and meta-analysis aimed to assess the safety of hemithyroidectomy in an outpatient setting compared to an inpatient setting. The objectives were to (1) find the proportion of PTB in patients scheduled for outpatient hemithyroidectomy, (2) examine if outpatient hemithyroidectomy is clinically safe compared to an inpatient setting and (3) evaluate which selection criteria are most relevant for hemithyroidectomy in an outpatient setting. Methods A systematic review was conducted using the following databases: MEDLINE (Ovid), EMBASE (Ovid) and the Cochrane Library from inception until September 2021. We included studies reporting on PTB of patients after hemithyroidectomy in an outpatient setting. The risk of bias was assessed using the Newcastle-Ottawa tool. The results were synthesised using Bayesian meta-analysis. Certainty in evidence was assessed using the GRADE approach. Results This review included 11 cohort studies and 9 descriptive studies reporting solely on outpatients resulting in a total of 46,866 patients. PTB was experienced by 58 of the 9025 outpatients (0.6%) and 415 of the 37,841 inpatients (1.1%). There was no difference between the PTB rate of outpatients and inpatients (RR 0.715 CrI [0.396–1.243]). The certainty of the evidence was very low due to the high risk of bias. Conclusion The risk of PTB in an outpatient setting is very low, and outpatient hemithyroidectomy should be considered clinically safe. The most relevant selection criteria to consider in outpatient hemithyroidectomy are (1) relevant comorbidities and (2) psycho/-social factors.

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“…Os impactos da tireoidectomia vêm melhorando com os anos (3) , mas além dos aspectos funcionais pode haver impacto negativo na qualidade de vida em voz, com redução no pré operatório (2,6) , e alterações emocionais (3,(8)(9)(10) associadas ao diagnóstico dos nódulos tireoidianos.…”

Section: Introductionunclassified

Qualidade de vida em voz e sintomas emocionais pré e pós-tireoidectomia

Oliveira

Santos³

et al. 2022

CoDAS

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RESUMO Objetivo Correlacionar a qualidade de vida em voz e sintomas de ansiedade e depressão pré e pós-tireoidectomia. Método Estudo observacional, longitudinal, prospectivo e quantitativo. Participaram 20 pacientes, com média de idade de 54 anos, submetidos à tireoidectomia, ao exame visual laríngeo e aos questionários Qualidade de Vida em Voz e Escala Hospitalar de Ansiedade e Depressão nos momentos: pré-operatório, 1 semana e 3 meses pós-tireoidectomia, com maior prevalência do sexo feminino (85%; n=17) e de tireoidectomia parcial (70%; n=14). Resultados Não houve diferença estatística quanto à qualidade de vida em voz entre os momentos, porém observaram-se menores escores no pré-operatório, com destaque para o domínio físico. Houve traço leve de ansiedade no pré-operatório com redução após 1 semana e aumento pós três meses. Houve correlação negativa moderada entre o domínio físico do QVV e a subescala de ansiedade e o escore total da HADS pós 1 semana e entre o domínio total do QVV com o escore total da HADS pós 1 semana, correlação negativa fraca entre o domínio total do QVV e a subescala de ansiedade da HADS pós 1 semana e o escore total da HADS pós 3 meses. Conclusão Os pacientes avaliados neste estudo autopercebem sua qualidade de vida relacionada à voz como positiva. Traços leves de ansiedade foram identificados, com redução no pós-operatório uma semana e aumento pós três meses. A autopercepção de melhor qualidade de vida em voz no pós-operatório relaciona-se, de forma fraca, com a redução dos níveis de ansiedade.

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Ambulatory thyroidectomy is safe and beneficial in papillary thyroid carcinoma: Randomized controlled trial

Cited by 8 publications

References 19 publications

Ambulatory Endoscopic Thyroidectomy via a Chest-Breast Approach Has an Acceptable Safety Profile for Thyroid Nodule

Ambulatory Endoscopic Thyroidectomy via a Chest-Breast Approach Has an Acceptable Safety Profile for Thyroid Nodule

Risk of hematoma after hemithyroidectomy in an outpatient setting: a systematic review and meta-analysis

Qualidade de vida em voz e sintomas emocionais pré e pós-tireoidectomia

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