To admit or not to admit? Experience with outpatient thyroidectomy for Graves' disease in a high-volume tertiary care center

Am J Surg. 2018 Nov;216(5):985-989. doi: 10.1016/j.amjsurg.2018.07.002. Epub 2018 Jul 10.

Abstract

Background: Outpatient thyroidectomy is increasingly performed. Thyroidectomy for Graves' disease, however, has greater risk of periprocedural complications, limiting use of same-day procedures. We sought to demonstrate that these patients may be managed with ambulatory surgery.

Methods: The experience of one endocrine surgeon with thyroidectomy for Graves' was examined from January 2016-November 2017. Forty-one patients met criteria. Patient demographics, perioperative parameters, and postoperative outcomes including emergency department utilization and readmission were recorded.

Results: Mean age was 31.5 ± 17.0 years, with 80% females. Mode ASA score was 3, and median operative time was 77 minutes (43-132). Complications included transient hypocalcaemia in 12%, and temporary laryngeal nerve palsy in 9.7%, with no permanent complications. Two patients were admitted immediately postoperatively for non-medical reasons. Thirty-day emergency rdepartment visits were noted in 9.7%, with subsequent readmission of 7%.

Conclusions: Outpatient total thyroidectomy is safe and effective with acceptable morbidity in the Graves' patient.

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Surgical Procedures*
  • Female
  • Graves Disease / surgery*
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Tertiary Care Centers*
  • Thyroidectomy*
  • Young Adult