Feasibility criteria for total thyroidectomy in outpatient surgery

Philippe, Jean-Baptiste; Riou, Jérémie; Lemoult, Annabelle; Sarfati-Lebreton, Marine; Hamy, A.; Mucci, S.

doi:10.1016/j.ando.2019.04.016

Cited by 6 publications

(3 citation statements)

References 26 publications

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“…Our findings were limited by the low use perioperative antithrombotic therapy. Other authors have also found no significant association between the use of antithrombotic medication and post‐thyroidectomy haematoma [6, 7]. However, in a meta‐analysis of six studies, Liu et al found antithrombotic medication to be significantly associated with post‐thyroidectomy haematoma (odds ratio 1.96, 95% CI = 1.55–2.49) [8]; suggesting the potential for a type II error in the individual studies including ours.…”

mentioning

confidence: 62%

Author's Reply: Reoperation for Bleeding After Thyroid and Parathyroid Surgery: Incidence, Risk Factors, Prevention, and Management

2020

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confidence: 62%

Author's Reply: Reoperation for Bleeding After Thyroid and Parathyroid Surgery: Incidence, Risk Factors, Prevention, and Management

2020

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“…Surgeons across 52 countries reported that outpatient thyroid surgery is most frequently performed by surgeons in the United States (63%) [19]. Nonetheless, other countries are starting to evaluate costs associated with their own healthcare systems and evaluation of factors that may help identify appropriate patients for outpatient thyroidectomy has been reported [20].…”

Section: International Trendsmentioning

confidence: 99%

Appropriate selection of candidates for outpatient thyroidectomy

Arenas

2021

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of review Although traditionally an inpatient procedure, outpatient thyroidectomy has gained traction as a viable and well tolerated alternative for selected patients, with an added benefit of cost savings. Recent findings Research on outpatient thyroidectomy has focused on establishing its noninferiority in outcomes compared to the standard inpatient or overnight observation. Numerous studies have found comparable low rates of postoperative complications and no increase in readmission. Selection criteria have been well established by professional societies and research studies support the selection bias benefitting appropriately selected patients. The primary benefit of outpatient thyroidectomy reported is a decrease in cost, though additional theoretical benefits such as decreased exposure to nosocomial infections. Summary Outpatient thyroidectomy is a well tolerated approach in appropriately selected candidates, with cost reduction benefits. Adherence to societal guidelines for patient selection is paramount.

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“…As healthcare costs continue to rise, there has been increased demand in the utilization of outpatient surgeries for increasingly invasive procedures (Hollenbeck et al 2015 ; Molins et al 2008 ). The advance of surgical and anesthesia techniques in combination with increasing pressure from insurance carriers have resulted in a substantial increase in thyroidectomies performed in the outpatient setting (Grubey et al 2018 ; Philippe et al 2019 ). Nonetheless, the safety of outpatient thyroidectomy is not well established and some surgeons still prefer to have patients admitted to a hospital after surgery (Balentine and Sippel 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis

et al. 2023

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Background To address the postoperative outcomes between outpatient and inpatient neck surgery involving thyroidectomy procedures. Methods A cohort analysis of surgical patients undergoing primary, elective, total thyroidectomy from multiple United States medical institutions who were registered with the American College of Surgeons National Surgical Quality Improvement Program from 2015 to 2018. The primary outcome was a composite score that included any 30-day postoperative adverse event. Results A total of 55,381 patients who underwent a total thyroidectomy were identified comprising of 14,055 inpatient and 41,326 outpatient procedures. A cohort of 13,496 patients who underwent outpatient surgery were propensity matched for covariates with corresponding number of patients who underwent inpatient thyroidectomies. In the propensity matched cohort, the occurrence of any 30-day after surgery complications were greater in the inpatient group, 424 out of 13,496 (3.1%) compared to the outpatient group, 150 out of 13,496 (1.1%), P < 0.001. Moreover, death rates were greater in the inpatient group, 22 out 13,496 (0.16%) compared to the outpatient group, 2 out of 13,496 (0.01%), P < 0.001. Similarly, hospital readmissions occurred with greater frequency in the inpatient group, 438 out of 13,496 (3.2%) compared to the outpatient group, 310 out of 13,496 (2.3%), P < 0.001. Conclusion Thyroidectomy procedures performed in the outpatient setting had less rates of adverse events, including serious postoperative complications (e.g., surgical site infection, pneumonia, progressive renal insufficiency). In addition, patients who had thyroidectomy in the outpatient setting had less 30-day readmissions and mortality. Surgeons should recognize the benefits of outpatient thyroidectomy when selecting disposition of patients undergoing neck surgery.

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Feasibility criteria for total thyroidectomy in outpatient surgery

Cited by 6 publications

References 26 publications

Author's Reply: Reoperation for Bleeding After Thyroid and Parathyroid Surgery: Incidence, Risk Factors, Prevention, and Management

Author's Reply: Reoperation for Bleeding After Thyroid and Parathyroid Surgery: Incidence, Risk Factors, Prevention, and Management

Appropriate selection of candidates for outpatient thyroidectomy

Outpatient compared to inpatient thyroidectomy on 30-day postoperative outcomes: a national propensity matched analysis

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