Guide to Enhanced Recovery for Cancer Patients Undergoing Thyroidectomy

Excerpt

In thyroid surgery, enhanced recovery after surgery (ERAS) may be most helpful to reduce complication rates and improve patient satisfaction. The most obvious symptom that can be minimized with optimized perioperative care is postoperative nausea and vomiting (PONV), which specifically, after thyroidectomy, may contribute to the complication of cervical hematoma requiring reoperation.1 Studies have shown decreased PONV after thyroid surgery by relying primarily on intravenous anesthetics, which is a key component of ERAS for thyroidectomy.2 Our own institutional implementation of ERAS for thyroidectomy and other cervical endocrine surgery showed a significant decrease in both PONV and postoperative opioid use.3 While there is limited evidence that ERAS can decrease hospital length of stay following thyroidectomy, as hospital stay is already reasonably short, by reducing PONV, the length of stay at some centers or in high-risk patients may indeed be reduced. There are no published data on the widespread implementation of enhanced recovery protocols for thyroidectomy; however, implementation of ERAS for other surgery types has shown a decrease in length of stay and overall costs.4 …