Outpatient versus inpatient thyroidectomy: A systematic review and meta‐analysis

Abstract

The results suggest outpatient thyroidectomy may be as safe as inpatient thyroidectomy in appropriately selected patients. The results are limited by high risk of bias. Well-designed prospective studies are necessary to further assess the safety of outpatient thyroidectomy.

Outpatient versus inpatient parotidectomy: Comparison of postoperative complication rates

“…15 Another study at the Fallon Clinic (Worcester, MA) similarly reported low complication rates and modest savings from same-day parotidectomies. 11 The studies on outpatient thyroidectomies are more extensive and report similar results in which the outpatient cohort have significantly reduced rates of complications. [9][10][11] Our findings, therefore, support the argument that outpatient parotidectomies are at least as safe as inpatient parotidectomies in selected patients.…”

“…11 The studies on outpatient thyroidectomies are more extensive and report similar results in which the outpatient cohort have significantly reduced rates of complications. [9][10][11] Our findings, therefore, support the argument that outpatient parotidectomies are at least as safe as inpatient parotidectomies in selected patients. Although there are potential liabilities to discharging patients the same day as their operation, there are also risks associated with longer hospital stays, as may be evidenced by this study.…”

“…One single‐institutional analysis comparing superficial and total parotidectomies performed as an outpatient versus inpatient procedure found comparatively low rates of procedure‐specific complications in the outpatient cohort, concluding that these procedures can be performed safely without overnight observation . Another study at the Fallon Clinic (Worcester, MA) similarly reported low complication rates and modest savings from same‐day parotidectomies . The studies on outpatient thyroidectomies are more extensive and report similar results in which the outpatient cohort have significantly reduced rates of complications .…”

“…Studies on other head and neck procedures, such as thyroidectomies, have paved the way for associations to outline inclusion and exclusion criteria for those procedures. In order for patients to be considered for outpatient management, the most important criteria include no major comorbidities (ASA class ≤ 3), preoperative education and understanding, a clinical team approach to care, an available and willing primary caregiver, appropriate and safe social surroundings, and proximity to a skilled facility . Extensive medical conditions including diabetes, chronic obstructive pulmonary disease, and cardiac disease are critical to evaluate prior to ambulatory surgery .…”

“…In order for patients to be considered for outpatient management, the most important criteria include no major comorbidities (ASA class ≤ 3), preoperative education and understanding, a clinical team approach to care, an available and willing primary caregiver, appropriate and safe social surroundings, and proximity to a skilled facility. 11 Extensive medical conditions including diabetes, chronic obstructive pulmonary disease, and cardiac disease are critical to evaluate prior to ambulatory surgery. 8 Prior to the use of propensity matching to reduce variability between our cohorts for outcomes analysis, our study found that there are numerous preoperative factors that prompt the decision for overnight hospital observation following parotidectomy (Table II).…”