Same day discharge after thyroidectomy is safe and effective
| العنوان: | Same day discharge after thyroidectomy is safe and effective |
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| المؤلفون: | Michael D. Bortz, Camille W. Graham, Victoria E. Wagner, Xiaohui Wang, Samuel K. Snyder, Susan V. Stafford, Henry A. Reinhart |
| المصدر: | Surgery. 164:887-894 |
| بيانات النشر: | Elsevier BV, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | medicine.medical_specialty, medicine.medical_treatment, Postoperative hematoma, Thyroid Lobectomy, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Hematoma, Humans, Medicine, Local anesthesia, Retrospective Studies, Same day discharge, business.industry, Thyroidectomy, Retrospective cohort study, Length of Stay, medicine.disease, Thyroid Diseases, Patient Discharge, Surgery, Ambulatory Surgical Procedures, Central Lymph Node Dissection, 030220 oncology & carcinogenesis, business |
| الوصف: | Historically, thyroidectomies have been performed as inpatient operations due to concerns of postoperative bleeding and symptomatic hypocalcemia. We aim to demonstrate that outpatient thyroidectomy can be performed safely.This report outlines a 7-year retrospective analysis (2009-2016) of outpatient vs inpatient thyroidectomies, with outcomes including hematoma, blood loss, recurrent laryngeal nerve injury, symptomatic hypocalcemia, and postoperative emergency room (ER) visits.A total of 1460 thyroidectomies were performed: 1272 (87%) outpatient and 188 (13%) inpatient. Five outpatients: 4 total thyroidectomies (TT), 1 TT with a central lymph node dissection (CLND), and 1 partial thyroidectomy (PT) developed postoperative hematomas (0.34%) at post-discharge hour 3, 9, 10, 13, and 42. Average time to discharge was 2 hours and 37 minutes. Hematomas were evacuated successfully in the operating room under local anesthesia with a 2-day average hospital stay. There were no differences between TT, thyroid lobectomy (TL), and PT procedures for postoperative hematoma (p=0.17). Outpatient compared to inpatient thyroidectomy was more likely to have been performed in patients with lower American Society of Anesthesia scores (2.3 vs 2.9, p0.0001), less mean blood loss (74 vs 227 ml, p0.0001), lesser age (52 vs 56 years, p=0.0012), less extensive dissection (p0.0001), and fewer RLN injuries (2.4% vs 8.5%, p0.0001). There was no difference between outpatient and inpatient symptomatic hypocalcemia (6.3% vs 9.6%, p=0.09), 30-day postoperative ER visits (8.8% vs 9.6%, p=0.73), and postoperative hematoma (0.39% vs 0%, p=0.39). There was one inpatient mortality from stroke.Postoperative hematomas can be managed safely without life-threatening complications suggesting outpatient thyroidectomy can be performed safely by an experienced surgeon, and adverse sequelae dealt with in a safe and effective manner. |
| تدمد: | 0039-6060 2009-2016 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ee0afb665487da2947d1a8075b82f90c https://doi.org/10.1016/j.surg.2018.06.019 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....ee0afb665487da2947d1a8075b82f90c |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 00396060 20092016 |
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