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World Journal of Surgery

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01-11-2014

Changing Trends in Thyroid and Parathyroid Surgery over the Decade: Is Same-day Discharge Feasible in the United Kingdom?

Authors: Parameswaran Rajeev, Rupesh Sutaria, Tarek Ezzat, Radu Mihai, Gregory P. Sadler

Published in: World Journal of Surgery | Issue 11/2014

Abstract

Background

A recent British Association of Endocrine and Thyroid Surgeons consensus document suggested that day-case thyroidectomy is feasible in a small proportion of patients but has to be balanced against risks. Currently, there is no large reported series of same-day discharge in thyroid and parathyroid surgery from the UK. The aim of this study was to assess the outcomes of day-case thyroid and parathyroid surgery.

Methods

We conducted a retrospective study of patients who underwent thyroid or parathyroid surgery between January 2000 and December 2011 at Oxford University Hospitals. The end points analysed were complications in the form of bleeding, hypocalcaemia, wound infection, and seroma.

Results

A total of 2,102 patients (495 males and 1,607 females, age range = 13–90 years) underwent surgery for parathyroid (n = 776) or thyroid (n = 1,326) conditions. The operations included minimally invasive parathyroidectomy (MIP) (n = 331), open parathyroidectomy (n = 445), lobectomy (n = 687), isthmusectomy (n = 23), total thyroidectomy (n = 580) and thyroglossal cyst excision (n = 36). Routine arrangements were in place for consideration of same-day discharge for lobectomies, thyroglossal cyst surgery, and MIPs; lobectomies accounted for 63 % of same-day cases, followed by parathyroidectomy (35 %). Over the decade, day-case surgery increased from 4 to 17 % for thyroid surgery and from 20 to 40 % for parathyroid surgery. None of the 435 patients who had same-day discharge was readmitted for bleeding [confidence interval (CI) 0–0.6 %]. There was no 30-day mortality for the whole cohort. Complications in patients who underwent surgery in the whole cohort versus those who were discharged the same day were temporary hypocalcaemia (4 vs. 0.2 %), permanent hypocalcaemia (1 vs. 0.4 %), bleeding (0.4 vs. 0 %), seroma (0.3 vs. 0 %), and wound infection (0.3 vs. 0 %).

Conclusion

Current protocols for thyroid or parathyroid surgery make same-day discharge feasible and safe in carefully selected patients.

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Title: Changing Trends in Thyroid and Parathyroid Surgery over the Decade: Is Same-day Discharge Feasible in the United Kingdom?
Authors: Parameswaran Rajeev
Rupesh Sutaria
Tarek Ezzat
Radu Mihai
Gregory P. Sadler
Publication date: 01-11-2014
Publisher: Springer US
Published in: World Journal of Surgery / Issue 11/2014
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-014-2673-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changing Trends in Thyroid and Parathyroid Surgery over the Decade: Is Same-day Discharge Feasible in the United Kingdom?

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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