Outpatient Thyroidectomy

Balentine, Courtney J.; Sippel, Rebecca S.

doi:10.1016/j.soc.2015.08.003

Cited by 49 publications

(61 citation statements)

References 34 publications

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“…Actually, in our opinion in a case with delayed PCH, the patient is more unlikely to return to the operating room within the first six hours from the bleeding onset. The outpatient thyroid surgery is defined either as discharge on the same day or after 23 h observation [20]. Although some authors recommend outpatient thyroidectomy as safe procedure [21], others conclude that outpatient thyroid surgery cannot be supported at this stage [6,7].…”

Section: -33mentioning

confidence: 99%

“…Although some authors recommend outpatient thyroidectomy as safe procedure [21], others conclude that outpatient thyroid surgery cannot be supported at this stage [6,7]. The recent review of Balentine and Sippel concluded that "Outpatient thyroid surgery is likely to remain controversial for the immediate future given concerns over the potential consequences of a neck hematoma" [20]. Due to the unpredictable risk of delayed PCH, the same authors propose strict selection criteria for outpatient thyroidectomy including support at home for 24 hours, access to a telephone, etc.…”

Section: -33mentioning

confidence: 99%

“…Due to the unpredictable risk of delayed PCH, the same authors propose strict selection criteria for outpatient thyroidectomy including support at home for 24 hours, access to a telephone, etc. [20].…”

Section: -33mentioning

confidence: 99%

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A rare case report of a delayed postoperative cervical hematoma after thyroid redo surgery

Dimov¹,

Mutafchiyski²,

Stanimirov³

et al. 2018

Int J Surg Med

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Introduction:A postoperative cervical hematoma is a relatively rare, but potentially life-threatening complication after thyroid surgery. However, few cases with delayed manifestation after discharge of the patient are available in the literature. Case report: A 63-year-old Caucasian woman underwent total thyroidectomy for recurrent benign nodular goitre. She was discharged on the next day in good condition. On the third postoperative day, she was brought to the emergency unconscious with respiratory distress and enormous swelling of the neck. She was reoperated immediately, and postoperative hematoma due to bleeding from a small branch of the left superior thyroid artery was found. Definitive hemostasis was done. She stayed ten days in the ICU on artificial ventilation until the swelling was relieved. Due to signs of infection the wound was opened and treated with negative pressure wound therapy at regular intervals. After extubation, she was found to have phonation and eyesight disorders, fully recovered by conservative treatment in three weeks. The overall length of hospital stay was 41 days, and she was discharged in good condition. Conclusion: Very rarely, a delayed manifestation of postoperative bleeding after thyroid surgery could be seen. In the light of one-day surgery, the real danger is the possible delay of life-saving surgery, and this should always be kept in mind. Unfortunately, as of today, no reliable predictive signs are heralding delayed bleeding. The prompt surgical re-intervention is of paramount importance for the successful outcome. In this case, we successfully managed the infection with negative pressure wound therapy with white foam, thus preventing life-threatening neck phlegmon and mediastinitis.

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Section: -33mentioning

confidence: 99%

Section: -33mentioning

confidence: 99%

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A rare case report of a delayed postoperative cervical hematoma after thyroid redo surgery

Dimov¹,

Mutafchiyski²,

Stanimirov³

et al. 2018

Int J Surg Med

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“…However, in recent years the volume of outpatient thyroidectomy has increased with patients being discharged on the same day or the morning after surgery. 8 Outpatient operating rooms can increase operative time efficiency and therefore increase operating room utilization by good patient selection and more efficient staffing. Safely performing outpatient thyroid surgery requires careful patient selection and preparation.…”

Section: During the Late 19mentioning

confidence: 99%

“…It is important to identify both social and medical factors that place patients at higher risk for complications. 8 If patient variables were known to contribute to a more difficult and potentially higher risk thyroid removal or result in a potentially longer operation, a surgeon would be able to appreciate these factors and take them into consideration when planning a thyroidectomy. This knowledge can improve operating room scheduling (cases in which more difficulty is anticipated scheduled earlier) and preoperative risk counseling.…”

Section: During the Late 19mentioning

confidence: 99%

Predicting difficulty of thyroidectomy preoperatively

Oommen

Remin

2017

Int Surg J

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Background: Today, thyroidectomy is a common operation used to treat various thyroid disorders. Nowadays, many high-volume thyroid surgeons are discharging patients on the same day of thyroidectomy. The incidence of complications following thyroidectomy is directly linked to the difficulty of the procedure. So, if we can predict the difficulty of thyroidectomy preoperatively, we can anticipate complications and decide on which patients will require in-patient care.Methods: A thyroidectomy difficulty scale was developed by Schneider and colleagues. This scale was used in our study to classify patients in to difficult thyroidectomy group and non-difficult thyroidectomy group. The association between preoperative variables and difficulty of thyroidectomy was studied.Results: Statistical analysis revealed that there was a significant association between hyperthyroidism and difficult thyroidectomy. Similarly, there was a significant association between positive anti-thyroid peroxidase antibody (which defines Hashimoto’s thyroiditis) and difficult thyroidectomy. Also, there was a significant association between positive anti-thyroglobulin antibody and difficult thyroidectomy. Difficult thyroidectomy was found to have a significant association with postoperative hypocalcemia. Statistical analysis also showed duration of surgery to have a significant association with difficulty of thyroidectomyConclusions: Patients with hyperthyroidism, positive anti-thyroid peroxidase antibodies, positive anti-thyroglobulin antibodies have a high probability of a difficult thyroidectomy, associated with longer operative times and increased complications. This information can improve preoperative risk counseling and lead to more efficient scheduling of the operating room.

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Outpatient vs inpatient parotidectomy: Systematic review and meta‐analysis

et al. 2020

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The primary aim of this study was to conduct a systematic review and meta-analysis to compare complications between outpatient vs inpatient parotidectomy. A systematic review was performed to identify patients undergoing either outpatient or inpatient partodiectomy, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, using PUBMED, SCOPUS, CINAHL, and the Cochrane library. Risk of bias was assessed using the Newcastle-Ottawa Scale. Postoperative complications (hematoma, seroma/sialocele, salivary fistula formation, Frey syndrome, surgical site infection [SSI]) were compared. Our search yielded 4958 nonduplicate articles, of which 13 studies were ultimately included (11 retrospective cohort, 2 prospective cohort), encompassing a total of 1323 patients (outpatient 46.33% vs inpatient 53.67%). There was no significant difference in total complications, hematoma, seroma, salivary fistula, or SSI rates between outpatient and inpatient groups. No significant difference in total complications was found between outpatient and inpatient groups when stratified by surgical approach (partial/superficial and total parotidectomy). Our findings suggest outpatient parotidectomy may be as safe as inpatient parotidectomy in appropriately selected patients.

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Outpatient Thyroidectomy

Cited by 49 publications

References 34 publications

A rare case report of a delayed postoperative cervical hematoma after thyroid redo surgery

A rare case report of a delayed postoperative cervical hematoma after thyroid redo surgery

Predicting difficulty of thyroidectomy preoperatively

Outpatient vs inpatient parotidectomy: Systematic review and meta‐analysis

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