Abstract
Objectives:
(1) Understand the principles for safe outpatient thyroid surgery. (2) Review the outcomes of outpatient thyroid surgery in a large patient cohort.
Methods:
A protocol for outpatient thyroidectomy was conceived and refined over 3 years. A prospective analysis of all thyroidectomies accomplished by a single surgeon using this protocol from May 2008 to November 2013 was then undertaken. Patient demographics, surgical and pathological data, admission status, and complication and readmission rates were recorded.
Results:
A total of 1311 thyroidectomy procedures were performed during the study period, of which 1018 (77.7 %) were conducted on an outpatient basis. The readmission rate for outpatients was 0.8%, with only 1 readmission in the last 200 procedures. Inpatients were readmitted more often than outpatients (3.9% vs 0.8%, P < .01). Outpatient management increased steadily throughout the study period (from 59.2% to 92.8%, P < .01), despite a larger mean nodule size and a higher rate of malignancy over time. There were no changes in the complication rate across the study timeframe except for the incidence of hypocalcemia, which decreased over time (P < .01).
Conclusions:
Outpatient thyroid surgery is safe in appropriately selected patients using an optimized and systematic protocol.