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  • Title: To admit or not to admit? Experience with outpatient thyroidectomy for Graves' disease in a high-volume tertiary care center.
    Author: Mallick R, Asban A, Chung S, Hur J, Lindeman B, Chen H.
    Journal: Am J Surg; 2018 Nov; 216(5):985-989. PubMed ID: 30007745.
    Abstract:
    BACKGROUND: Outpatient thyroidectomy is increasingly performed. Thyroidectomy for Graves' disease, however, has greater risk of periprocedural complications, limiting use of same-day procedures. We sought to demonstrate that these patients may be managed with ambulatory surgery. METHODS: The experience of one endocrine surgeon with thyroidectomy for Graves' was examined from January 2016-November 2017. Forty-one patients met criteria. Patient demographics, perioperative parameters, and postoperative outcomes including emergency department utilization and readmission were recorded. RESULTS: Mean age was 31.5 ± 17.0 years, with 80% females. Mode ASA score was 3, and median operative time was 77 minutes (43-132). Complications included transient hypocalcaemia in 12%, and temporary laryngeal nerve palsy in 9.7%, with no permanent complications. Two patients were admitted immediately postoperatively for non-medical reasons. Thirty-day emergency rdepartment visits were noted in 9.7%, with subsequent readmission of 7%. CONCLUSIONS: Outpatient total thyroidectomy is safe and effective with acceptable morbidity in the Graves' patient.
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