Day Case Thyroid Surgery: Time for a paradigm shift worldwide?

  • Background.
    Day case thyroid surgery has often been controversial due to potential immediate complications. However, in recent years day case thyroid surgery has increased in prevalence, especially in the United States with complication rates that are the same, if not slightly better than 23-hour surgery1,2. Our group aimed to evaluate the safety of day case thyroid surgery in a regional head and neck centre.

    Methods.
    Single centre retrospective cohort analysis from January 2013 to April 2018 looking at all patients who had hemithyroidectomy, completion thyroidectomy and total thyroidectomy both day case and inpatient. Immediate and delayed complications including 30-day mortality, readmission/re-intervention, haematoma, hypocalcaemia and recurrent laryngeal nerve palsy were evaluated.

    Results.
    76 of 266 patients (28.6%) in our unit underwent day case thyroidectomy of which 71 were hemithyroidectomy and 5 completion thyroidectomy with or without level 6 neck dissection. Rate of recurrent laryngeal nerve neuropraxia was 6.5% all of which were successfully managed conservatively. There were no cases of permanent vocal cord palsy. One patient had a post operative seroma and one a superficial wound infection managed with antibiotics. No patients were readmitted or required further intervention.

    Discussion & Conclusion.
    Day case thyroid surgery can be done safely in centres conducting appropriate volumes of procedures and patient selection is appropriate.

 

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