Safety of Same Day Discharge in Patients Undergoing Sutureless Thyroidectomy: A Comparison of Local and General Anesthesia

Inabnet, William B.; Shifrin, Alexander; Ahmed, Leaque; Sinha, Prashant

doi:10.1089/thy.2007.0148

Cited by 68 publications

(73 citation statements)

References 20 publications

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“…[9][10][11][12][13][14][15][16][17][18][19][20][21] In the UK, the British Association of Day Surgery included thyroidectomy as a potential day-case procedure in 2001 but the 2011 consensus statement of the British Association of Endocrine and Thyroid Surgeons (BAETS) was more cautious, recommending that thyroidectomy should be a 'day-and-stay' procedure with a minimum length of stay of 23 hours. 22 This study examined the pattern and timing of post-thyroidectomy haemorrhage in a large interdisciplinary district hospital to identify potential risk factors for this complication as well as the extent to which its impact on preventing short stay thyroid surgery may be mitigated.…”

mentioning

confidence: 99%

Patterns, timing and consequences of post-thyroidectomy haemorrhage

Farooq

Nouraei

Kaddour

et al. 2017

annals

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INTRODUCTION Post-thyroidectomy bleeding is a low frequency but potentially life threatening event that is very difficult to predict. Given the increasing drive towards thyroidectomy with same day discharge, this study was conducted with the aim of identifying patterns, timing and consequences of post-thyroidectomy bleeding to assess the feasibility of day-case thyroidectomy. METHODS All patients who underwent a thyroidectomy between 2008 and 2015 at our institution were identified. Patterns, timing and consequences in all those who developed post-thyroidectomy bleeding were studied. RESULTS Of the 805 patients included in the study, 14 required re-exploration for bleeding; 7 (50%) of these within 8 hours of surgery, 6 (43%) between 18 and 30 hours, and 1 (7%) at 49 hours. Just under half (43%) of those with post-thyroidectomy bleeding had thyrotoxicosis. CONCLUSIONS A significant number of postoperative haemorrhages occurred beyond the immediate postoperative period. Same day discharge after thyroidectomy cannot therefore be recommended as a routine practice.

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mentioning

confidence: 99%

Patterns, timing and consequences of post-thyroidectomy haemorrhage

Farooq

Nouraei

Kaddour

et al. 2017

annals

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“…Five studies (6,15,17,19,21) comprising 1,717 cases identified the proportion of outpatients with a transient RLN injury and reported results ranged from 0-4% (6,15). Only one study by Snyder et al (6) reported on inpatient and outpatient results (Figure 3).…”

Section: Transient Recurrent Laryngeal Nerve (Rln) Injurymentioning

confidence: 99%

“…Ten studies comprising 2,505 cases reported on permanent RLN injury in OPS cases (5,6,8,13,15,(17)(18)(19)21), with rates ranging from 0-2% (13,18,19). There were 11 reported cases (0.4%) of vocal cord paralysis.…”

Section: Permanent Rln Injurymentioning

confidence: 99%

“…There were eight studies that reported on transient hypocalcemia in OPS cases (5,6,8,13,15,17,19,21) (2,455 cases) with a reported incidence from 1-21% (6,19).…”

Section: Hypocalcemiamentioning

confidence: 99%

“…Thirteen studies (3,5,6,8,12,13,(15)(16)(17)(18)(19)(20)(21) reported on the rate of hematoma formation which ranged from 0-2% (3,5,6,12,15,16,20,21). A meta-analysis of 2,760 outpatients was performed and there were 8 total cases of hematoma formation (0.02%).…”

Section: Hematomamentioning

confidence: 99%

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Safety of same-day thyroidectomy: meta-analysis and systematic review

Khadra¹,

Mohamed²,

Hauch³

et al. 2017

Gland Surg.

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Background: Performance of thyroid surgery as a same day surgery procedure has been a controversial topic. This study aimed to compare the safety and efficacy of outpatient thyroid surgery with inpatient thyroid surgery by meta-analysis of current literature.Methods: Articles were identified from the following keyword searches: outpatient thyroidectomy/thyroid surgery, same day thyroidectomy/thyroid surgery. Outcomes included perioperative complications including recurrent laryngeal nerve (RLN) injury, hypocalcemia, and readmissions. Data were extracted following review of appropriate studies by authors and random effects models were used.Results: 34 potentially relevant publications were identified and 14 studies fulfilled the predetermined inclusion criteria, totaling 10,478 patients, 4,565 of whom were discharged the same day following thyroid surgery. There was no difference in malignancy rate between the two groups (95% CI, 0.84-2.31; P=0.196).Inpatient group were 2.23 times (95% CI, 1.36-3.36; P=0.001) more likely to develop transient RLN injury and 2.32 times (95% CI, 1.06-5.06; P=0.034) more likely to have documented transient hypocalcemia compared to outpatients. Inpatient groups were 2.10 times (95% CI, 1.33-3.33; P=0.002) more likely to have documented other complications. The two groups also had similar readmission rates (95% CI, 0.71-1.41; P=1.000).Conclusions: Our meta-analysis suggests that discharging selective patients the same day after a thyroid surgery is as safe, feasible, and efficacious as admitting them for observation. Admitting patients after thyroid surgery is associated with higher reported risk of complications.

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