Short-stay thyroid surgery

Sahai, Amit; Symes, Andrew; Jeddy, T A

doi:10.1002/bjs.4746

Cited by 51 publications

(34 citation statements)

References 2 publications

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“…After that time, with the development of newer and safer anesthetic techniques, and with the modern intravenous anaesthetic agents like propofol, midazolam, and fentanyl, thyroidectomy was performed exclusively under general anaesthesia and in inpatient settings. The current trend now favors minimally invasive thyroid surgery techniques, ambulatory approach, shortening of hospital stay and once more utilizes preferably Local anaesthesia + Monitored Anaesthesia Care (LA + MAC) (1)(2)(3)(4)(5)(6). However, the complexity of the procedure may vary from excision of a single nodule to removal of the entire thyroid gland with lymph dissection to treat cancer, or extirpation of a retrosternal goitre to relieve tracheal compression.…”

Section: Introductionmentioning

confidence: 99%

General or Local Anaesthesia in One-Day Thyroid Surgery-Does It Matter?

Belitova¹,

Pandev²,

Karadimov³

2012

Balkan Med J

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Objective: We aimed to determine the safety and feasibility of general anaesthesia (GA) compared with local anaesthesia + Monitored Anaesthesia Care (LA+MAC) for One-Day Thyroid Surgery (ODTS); to assess patient and operator satisfaction with either of the anesthetic approaches. Material and Methods:We reviewed prospectively 130 patients who underwent ODTS from 2008 to 2011. 64 patients were operated on under GA and 62 -under LA+MAC. All variables of patient demographic characteristics, duration and type of operation, postoperative complications, difficulty in airway management and postoperative opiate consumption were recorded and analyzed.Results: There is no difference in respect to length of stay, discharge time and major/minor complications rate between two groups, but in the LA+MAC group, pain appears earlier and is more severe (56min; VAS 6, 5) than in GA patients (223 min; VAS 1, 5; p<0.001). Patient satisfaction was similar but the operator preference was greater for GA. Conclusion:In experienced hands LA with MAC for Thyroidectomy is a safe and wise choice, but GA is even more so!

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Section: Introductionmentioning

confidence: 99%

General or Local Anaesthesia in One-Day Thyroid Surgery-Does It Matter?

Belitova¹,

Pandev²,

Karadimov³

2012

Balkan Med J

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“…2 Several studies, the majority from North America, have concluded that day-case thyroidectomy is a safe and cost effective procedure. [3][4][5] In the UK, the current median postoperative length of stay following total thyroidectomy is 2 days. 1 True day surgery with no overnight stay has only increased from 3% in 2007 to 6% in 2012.…”

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confidence: 99%

Thyroid surgery as a 23-hour stay procedure

Perera

Patel

2014

annals

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INTRODUCTIONThe main barriers to short stay thyroidectomy are haemorrhage, bilateral recurrent laryngeal nerve palsy causing respiratory compromise and hypocalcaemia. This study assessed the safety and effectiveness of thyroidectomy as a 23-hour stay procedure. METHODS All patients undergoing total or completion thyroidectomy were prescribed calcium and vitamin D 3 supplements following surgery. Retrospective analysis identified patients admitted for longer than 23 hours and any readmissions. RESULTS A total of 164 patients were admitted for 23-hour stay thyroid surgery over a 25-month period between 2008 and 2010. Four patients (2%) required admission for longer than 23 hours. No patients required emergency intervention for postoperative haemorrhage or airway compromise. Biochemical hypocalcaemia (despite calcium supplements) was detected in one patient when measured at the outpatient clinic two weeks following surgery. Twelve patients (7.3%) attended the accident and emergency department following discharge; four required admission for intravenous antibiotics for wound infection and one for biochemical hypocalcaemia. CONCLUSIONS This single centre UK experience demonstrates that thyroidectomy can be carried out both safely and effectively as a 23-hour stay procedure. Prophylactic prescription of calcium and vitamin D 3 reduces hypocalcaemia, and thereby also prolonged admission and readmission due to hypocalcaemia. Supplements are an acceptable, cost effective method of reducing hypocalcaemia and shortening postoperative length of stay.

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“…[1][2][3][4] Hemorrhage can be life threatening which makes most of the surgeons to put the drain in thyroid surgery though the actual incidence is only 0.3 -1%. 1,5,[6][7][8] A number of studies have also failed to show any advantages of the drain in thyroid surgery.…”

Section: Introductionmentioning

confidence: 99%

Hemithyroidectomy with or without use of drain a randomized prospective clinical study

2018

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Background: The practice of using the drain in thyroid surgery including hemithyroidectomy is common to avoid complications like a hematoma. The aim of this study is to evaluate the necessity of routine drainage in hemithyroidectomy.Methods: In this randomized prospective clinical study conducted in tertiary care government training hospital,60 patients who underwent hemithyroidectomy for various thyroid disorders were randomly allocated to either non-drainage (group A) or drainage (group B). The various complications including hematoma, seroma, wound infection, post-operative pain, the length of hospital stay was then compared.Results: Both groups were comparable according to age, gender, thyroid size and histopathological diagnosis. A total number of 60 patients evaluated among them 45 females (75%) and 15 males (25%) were there. No significant difference in complications was observed between two groups regarding hematoma, wound infection, but the length of hospital stay was significantly reduced in the non-drainage group compared to drainage group (p-0.004), along with the significant reduction in post-operative pain (p-0.001).Conclusions: In present study, author observed that there is a significant reduction in length of hospital stay and post-operative pain in non-drainage group compared to drainage group. So suction drainage should be done in selected patients rather than a routine procedure and it is safe without suction drain especially in hands of experienced surgeons.

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Short-stay thyroid surgery

Abstract: Achieved in 104 consecutive procedures

Cited by 51 publications

References 2 publications

General or Local Anaesthesia in One-Day Thyroid Surgery-Does It Matter?

General or Local Anaesthesia in One-Day Thyroid Surgery-Does It Matter?

Thyroid surgery as a 23-hour stay procedure

Hemithyroidectomy with or without use of drain a randomized prospective clinical study

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