An Evaluation of Postoperative Complications and Cost After Short-Stay Thyroid Operations

Abstract

Selective SS thyroidectomy can be safe and cost effective, with few overall complications in patients undergoing more complex operations involving larger thyroids who were admitted to hospital.

Risk factors for post-thyroidectomy haemorrhage: a meta-analysis

“…Compared with conservative methods, thyroid surgery is a relatively safe method for treating several kinds of thyroid diseases; however, the thyroid gland is an organ with a high blood flow rate, and it is not surprising that post-thyroidectomy haemorrhage is a complication of thyroid surgery. The incidence of post-thyroidectomy haemorrhage reported in the literature varies between approximately 0.43% and 4.39% (2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26), but the major centres in developed countries commonly report the incidence of post-thyroidectomy haemorrhage as less than 2%.…”

Ambulatory thyroidectomy: an anesthesiologist’s perspective

“…Cost comparison between outpatient and inpatient thyroidectomy was reported in three papers 1,13,17. In all cases outpatient care was cost effective.…”

“…This is independent of the type of health care system the procedure is being performed in. Three papers in this analysis by Terris et al1, Lacroix et al13 and Narayanan et al17 briefly discussed cost difference between inpatient and outpatient thyroid surgery. In all three reports, outpatient care conferred a significant cost saving.…”

23-hour observation endocrine neck surgery: lessons learned from a case series of over 1700 patients

“…There is a widespread opinion that these procedures have a very low rate of complications (5)(6)(7). According to these assumptions, thyroidectomy and parathyroidectomy are actually practiced in short hospital stay systems (8)(9)(10). Until the present century, the risks of life-threatening complications, such as haemorrhage with subsequent airway obstruction, and hypocalcaemia had limited these short stay protocols at a minimum of two postoperative days (11).…”

“…As the hypocalcaemia is the most common morbidity associated with thyroid surgery, it should be the more prominent reason for the decision concerning the time of the discharge, but even the compressive hematoma, although rare, plays an important role in this decisionmaking, since it is a life threatening complication (12,13). Moreover, the inferior laryngeal nerve palsy causes respiratory compromise only if bilateral (8,9,14). According to the literature available, at our institution a 23-hour-surgery with overnight hospital stay for endocrine neck surgery was introduced at the beginning of the XXI century and systematically adopted since 2004.…”