Hemithyroidectomy using local or general anaesthesia: Results of a local regional hospital

Abstract

Aim Thyroidectomy is commonly performed for benign and malignant diseases of the thyroid gland. We report our results of performing hemithyroidectomy under local anaesthesia (LA) or general anaesthesia (GA) in a local tertiary hospital. Patients and Methods Patients’ demographic data, operative time, length of hospital stay and complications were recorded. Multiple regression analyses were used to assess the risk‐adjusted endpoints. The mean follow up was 12.6 months. Results From January 2010 to December 2014, 279 patients underwent hemithyroidectomy, of which 229 (82 per cent) were under GA. The mean age was 50.0 ± 14.6 years, and 238 (85 per cent) patients were female. In the univariate analysis, GA was associated with a longer operative time (99.3 vs 75.4 min, P = 0.011) and a longer hospital day (2.3 vs 1.4 days, P < 0.001). After adjusting for other covariates with multiple regression analyses, GA was still associated with a longer operative time by 16.1 min (P = 0.006) and a longer hospital stay by 1.15 days (P < 0.001). It had a higher complication rate (odds ratio = 3.26, P = 0.181), albeit not statistically significant. Conclusions Hemithyroidectomy under LA is associated with a shorter operative time and hospital stay, and is a safe and viable alternative to GA in selected patients.

Day surgery for total or completion thyroidectomy: The first report in Hong Kong

“…We successfully performed HT under LA for selected cases, which was supported by another study . The benefits of HT under LA are faster recovery and shorter hospital stay, with similar complications to its GA counterpart.…”

“…Intravenous sedation (diazepam 2.5–5 mg or midazolam 1–2.5 mg at the discretion of surgeons) and analgesics (pethidine 25–50 mg) were also given before procedure. We used the lateral approach by dissecting between the sternomastoid and strap muscles to expose the thyroid lobe . Thereafter, the procedure was proceeded akin to GA cases.…”

“…At our institution, DS is advocated by both surgeons and anaesthetists. DS for HT under local anaesthesia (LA) was launched more than 10 years ago, and its practicality and safety have been verified by us . Motivated by the advantages and successful experience in ambulatory HT, we took a step further and explored the feasibility of day total or completion thyroidectomy (TTCT).…”