Early discharge after total thyroidectomy: a retrospective feasibility study

Tartaglia, Francesco; Giuliani, Alessandro; Sorrenti, Salvatore; Tromba, L; Carbotta, Sabino; Maturo, A; Carbotta, Giovanni; L, De Anna; Merola, Raffaele; Livadoti, Giada; Pelle, Fabio; Ulisse, Salvatore

doi:10.11138/gchir/2016.37.6.250

Cited by 6 publications

(5 citation statements)

References 53 publications

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“…There has been some work on outpatient thyroid surgery but its safety and costeffectiveness are not yet clearly proved. 30,31 CONCLUSION Thyroid surgery is a safe procedure to be performed for teaching purposes in a high volume unit like ours with complication rates reaching near zero. But this study has the following strengths and limitations.…”

Section: Srmentioning

confidence: 78%

Outcome of one year’s experience of thyroid surgery in a high volume center.

Asghar

Kaleem

Afzal

et al. 2020

TPMJ

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Objectives: This study was performed to take an overview of the modes of presentation of these disorders, demographic factors of presenting patients, procedures to deal with these disorders and complications associated with them in our surgical ward. Study Design: Cross Sectional Study. Setting: Department of North Surgery, Mayo Hospital Lahore Pakistan. Period: September 2018 to September 2019. Material & Methods: All adult patients of either gender who presented with benign or malignant thyroid disorders and were managed surgically during the study period were included. The data was recorded on a pre-designed proforma maintained at the department. Results: Out of 156 patients, there were 146(93.6%) females and 10(6.4%) males. The most commonly performed procedure was total thyroidectomy i.e 102 (65.3%) while hemi thyroidectomies being 41 (26.1%). We performed 4 neck dissections in this time period for malignancies. The mean hospital stay ranged from 1-12 days with a mean of 2.88±1.99 days. There was no in-hospital mortality. Temporary hypocalcemia was the most common early complication found in 32(20.5%) patients. Conclusion: Thyroid surgery is a safe procedure to be performed for teaching purposes in a high volume unit like ours with complication rates reaching near zero.

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Section: Srmentioning

confidence: 78%

Outcome of one year’s experience of thyroid surgery in a high volume center.

Asghar

Kaleem

Afzal

et al. 2020

TPMJ

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“…However, drains usage may be omitted as unnecessary in uncomplicated cases because the drained volume is frequently very low, or because haemostasis was adequate during surgery [ 14 , 15 ]. In light of improvements in haemostatic techniques and increasing surgical skills, the value of drainage in thyroid surgery may again be questioned; using energy devices and advanced hemostatic agents could reduce drain output, making the use of drainage tubes less useful [ 16 , 17 , 18 , 19 , 20 ]. However, we believe that life-threatening complications (such as postoperative bleeding, haematoma, compression of the airways, or suffocation) can be more promptly signaled by the presence of drains, and can guarantee the surgeon a timelier diagnosis and a less rapid onset of symptoms associated with haematoma for patients [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Usefulness of the Valsalva Manoeuvre to Improve Hemostasis during Thyroidectomy

Pacilli

Pavone

Gerundo

et al. 2022

JCM

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Bleeding after total thyroidectomy remains a rare event that affects early postoperative morbidity, occurring in 0.3% to 4.2% of cases. Intraoperative bleeding is an unpleasant complication, and it is often easily manageable, although postoperative bleeding may represent a life-threatening condition for the patient. The purpose of our study was to clarify the role of the Valsalva manoeuvre to reduce postoperative bleeding. Between January 2019 to February 2022, 250 consecutive patients were listed for thyroid surgery at our surgical department. The study cohort consisted of 178 patients, divided into two groups based on the execution of the Valsalva manoeuvre. There was no difference in the duration of surgery between groups. Group B had fewer reinterventions for bleeding. Group A had a significantly greater volume of drainage output than Group B. Cervical haematoma can compromise a patient’s life, so bleeding control is crucial. Our results show that using a simple and safe Valsalva manoeuvre can improve the postoperative course with a significant reduction in drainage output, but does not prevent the risk of reoperation for hemorrhage.

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“…Most surgeons are interested in predicting early hypocalcemia after thyroidectomy. The early prediction of hypocalcemia may be necessary for the timely treatment and prevention of it and reduce hospital stay [ 15 ]. Some surgeons showed that patients with a <80% PTH level reduction could be safely discharged on the day of surgery [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Some surgeons showed that patients with a <80% PTH level reduction could be safely discharged on the day of surgery [ 16 ]. Others expected but failed to predict the early discharge at 24 h posttotal thyroidectomy based on the postoperative day 1 PTH and Ca levels or delta PTH and Ca levels without considering the complications [ 15 ]. However, the morbidity of postoperative hypocalcemia is the most common cause of prolonged hospital stay after thyroidectomy [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…The clinical and demographic parameters including diabetes, thyrotoxicosis, malignant pathology, age, female gender, and parathyroid gland number are all indicated as risk factors for asymptomatic and transient hypocalcemia [ 8 , 9 , 23 ]. The probability of age as a risk factor for postoperative hypocalcemia has been controversial until now [ 8 , 15 , 18 , 25 ]. The mechanism for the association of age and female gender with postoperative hypoparathyroidism has not been investigated.…”

Section: Discussionmentioning

confidence: 99%

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Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study

Shang

Wang

et al. 2020

International Journal of Endocrinology

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Objective. We performed this study to investigate the risk factors for postoperative hypocalcemia after total thyroidectomy with central lymph node dissection (CLND). Study Design. This was a single-center prospective study based on 176 consecutive patients who underwent total thyroidectomy for papillary thyroid carcinoma. Setting. Patients were recruited between January 2016 and June 2018. Subjects and Methods. Patients who underwent bilateral (n = 155, bilateral group) and ipsilateral CLND (n = 21) after total thyroidectomy were included. The preoperative and postoperative parathyroid hormone (PTH) and calcium levels were detected. The risk factors for transient hypocalcemia were identified using logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Results. Fifty-one (28.98%) patients developed transient hypocalcemia, and 2 patients (1.14%) developed permanent hypoparathyroidism. There was no difference in the gender ratio or the morbidity of hypocalcemia between the patients who underwent bilateral and ipsilateral CLND. On postoperative day 1, PTH decrease was a risk factor for transient hypocalcemia in the whole cohort (β = 0.043, OR = 1.044, 95% CI 1.023–1.065, p<0.001), bilateral group (β = 0.042, OR = 1.043, 95% CI 1.022–1.064, p<0.001), and female patients (β = 0.049, OR = 1.050, 95% CI 1.026–1.075, p<0.001). Tumor diameter was a risk factor for transient hypocalcemia in female patients (β = 0.499, OR = 1.647, 95% CI 1.003–2.704, p=0.049). The ROC curve analysis illustrated that 65.58%, 71.00%, and 71.00% PTH level reduction had high accuracy in predicting transient hypocalcemia in the whole cohort, bilateral group, and female patients, respectively (AUC = 0.986, 0.987, and 0.987). Conclusion. Asymptomatic female patients with bilateral CLND and a 71.00% PTH level reduction were at a high risk of transient hypocalcemia.

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Early discharge after total thyroidectomy: a retrospective feasibility study

Cited by 6 publications

References 53 publications

Outcome of one year’s experience of thyroid surgery in a high volume center.

Outcome of one year’s experience of thyroid surgery in a high volume center.

Clinical Usefulness of the Valsalva Manoeuvre to Improve Hemostasis during Thyroidectomy

Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study

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