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Short stay thyroidectomy

S A R Nouraei, J S Virk, S E Middleton, P Aylin, A Mace, F Vaz, H Kaddour, A Darzi, N S Tolley
OBJECTIVES: Thyroid conditions are common and their incidence is increasing. Surgery is the mainstay treatment for many thyroid conditions, and understanding its utilisation trends and morbidity are central to improving patient care. DESIGN: An N=near-all analysis of the English administrative dataset to identify trends in thyroid surgery specialisation, volume-outcome relationships, and the incidence and risk factors for short- and long-term morbidity. MAIN OUTCOME MEASURES: Between 2004 and 2012, 72594 patients underwent elective thyroidectomy in England...
August 20, 2016: Clinical Otolaryngology
Sumana Narayanan, Dena Arumugam, Steven Mennona, Marlene Wang, Tomer Davidov, Stanley Z Trooskin
BACKGROUND: Concern for postoperative complications causing airway compromise has limited widespread acceptance of ambulatory thyroid surgery. We evaluated differences in outcomes and hospital costs in those monitored for a short stay of 6 h (SS), inpatient observation of 6-23 h (IO), or inpatient admission of >23 h (IA). METHODS: We retrospectively reviewed all patients undergoing thyroidectomy from 2006 to 2012. The incidence of postoperative hemorrhage, nerve dysfunction, and hypocalcemia were evaluated, as well as cost data comparing the SS and IO groups...
May 2016: Annals of Surgical Oncology
Brian Hung-Hin Lang, Felix Che-Lok Chow
BACKGROUND: Unplanned 30-day readmission and emergency department (ED)/general practitioner (GP) visit after thyroidectomy are important healthcare quality measures and may reduce any cost savings from performing it as a short-stay (<24-h admission) procedure. Our study aimed to examine the incidence, cause, and risk factors for unplanned 30-day readmissions and ED/GP visits together following short-stay thyroidectomy. METHODS: One-thousand and four patients who underwent short-stay thyroidectomy were reviewed...
February 2016: World Journal of Surgery
Jingge Yang, Cunchuan Wang, Jinyi Li, Wah Yang, Guo Cao, Hong-Meng Wong, Hening Zhai, Weijun Liu
BACKGROUND: Natural orifice translumenal endoscopic surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and Society of American Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) is gaining interest because it allows operations without skin incisions. The aim of this study was to evaluate the feasibility, safety, and cosmetic results of endoscopic thyroidectomy via the oral vestibular approach (ETOVA) compared with endoscopic thyroidectomy via the areola approach (ETAA) in patients with thyroid diseases...
June 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Joshua Klopper, Madeleine Kane, Antonio Jimeno, Sharon Sams, Jena French, Laura Pike, Kenneth Tompkins, Bryan Haugen
No abstract text is available yet for this article.
May 2015: Thyroid: Official Journal of the American Thyroid Association
Yichao Wang, Kai Liu, Junjie Xiong, Jingqiang Zhu
BACKGROUND: The objective of this study was to conduct a meta-analysis to assess the safety and efficacy of total endoscopic thyroidectomy (TET) versus conventional open thyroidectomy (COT) for papillary thyroid microcarcinoma with regard to short-term clinical outcomes. METHODS: MEDLINE, EMBASE, Science Citation Index Expanded, and the Cochrane Central Register of Controlled Trials in the Cochrane Library between January 1996 and July 2014 were searched to identify relevant comparative studies...
March 2015: Journal of Craniofacial Surgery
Akif Enes Arikan, Serkan Teksoz, Yusuf Bukey, Sina Ferahman, Murat Ozcan, Recep Ozgultekin, Ates Ozyegin
Hospitalizing patients up to 72 hours after thyroidectomy is a classical approach. However, the length of hospitalization has decreased following surgical procedures with new technological devices. Seven hundred one consecutive patients who underwent sutureless total thyroidectomy (STT) between October 2011 and 2013 were included in this study. Six hundred seventy-two (95.9%) were discharged before 24 hours following surgery (short-stay = SS), and 29 were discharged later (delayed-discharge = DD). This study aims to assess short-stay STT with early postoperative complications and readmission to hospital...
November 2014: Surgical Technology International
Mohamed Abdelgadir Adam, Paul Speicher, John Pura, Michaela A Dinan, Shelby D Reed, Sanziana A Roman, Julie A Sosa
BACKGROUND: We describe nationally representative patterns of utilization and short-term outcomes from robotic versus open thyroidectomy for thyroid cancer. METHODS: Descriptive statistics and multivariable analysis were used to analyze patterns of use of robotic thyroidectomy from the National Cancer Database (2010-2011). Short-term outcomes were compared between patients undergoing robotic versus open thyroidectomy, while adjusting for confounders. RESULTS: A total of 68,393 patients with thyroid cancer underwent thyroidectomy; 225 had robotic surgery and 57,729 underwent open surgery...
November 2014: Annals of Surgical Oncology
A H Perera, S D Patel, N W Law
INTRODUCTION: The 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 D3 supplements following surgery. Retrospective analysis identified patients admitted for longer than 23 hours and any readmissions...
May 2014: Annals of the Royal College of Surgeons of England
Gabriele Materazzi, Lorenzo Fregoli, Gabriele Manzini, Angelo Baggiani, Mario Miccoli, Paolo Miccoli
BACKGROUND: No studies have compared robot-assisted transaxillary thyroidectomy (RATT) and minimally invasive video-assisted thyroidectomy (MIVAT) regarding cosmetic outcome and satisfaction METHODS: Patients matching the inclusion criteria (benign nodule less than 4 cm and thyroid volume less than 30 mL) were randomly allotted to undergo MIVAT (group A) or RATT (group B). Cosmetic result, overall satisfaction, operative time, and complications were evaluated. RESULTS: A total of 62 patients underwent hemithyroidectomy (30 in group A and 32 in group B)...
June 2014: World Journal of Surgery
E Kalemera Ssenyondo, J Fualal, J Jombwe, M Galukande
INTRODUCTION: In many facilities, drains are routinely inserted after thyroidectomy with the aim of preventing hematoma formation and accumulation of seroma. The continued use of drains may be based more on tradition rather than proven scientific evidence. OBJECTIVE: To assess the benefit of drain use after thyroidectomy by determining; length of hospital stay, post operative pain and wound sepsis. METHODS: This was a randomized controlled trial, carried out at a tertiary national referral hospital (Mulago, Kampala)...
September 2013: African Health Sciences
Myriam Loyo, Ralph P Tufano, Christine G Gourin
OBJECTIVES/HYPOTHESIS: To characterize contemporary patterns of thyroid surgical care and the effect of volume status on surgical care and short-term outcomes. STUDY DESIGN: Retrospective cross-sectional study. METHODS: Discharge data from the Nationwide Inpatient Sample for 871,644 patients who underwent surgery for thyroid disease in 1993 through 2008 were analyzed using cross-tabulations and multivariate regression modeling. RESULTS: Surgical cases increased from 364,288 in 1993 through 2000 to 507,356 in 2001 through 2008, with an increase in thyroid cancer surgical cases from 28% to 34%...
August 2013: Laryngoscope
Sara Vrabec, Sarah C Oltmann, Nicholas Clark, Herbert Chen, Rebecca S Sippel
BACKGROUND: Patients traditionally recover overnight on a general surgery ward after a thyroidectomy; however, these units often lack the efficiency and focus for rapid discharge, which is the goal of a short-stay (SS) unit. Using an SS unit for thyroidectomy patients, who are often discharged in <24 h, may reduce the duration of hospital stay and subsequently decrease associated costs and increase hospital bed and resource availability. METHODS: A retrospective review of 400 patients undergoing thyroidectomy at a single academic hospital...
September 2013: Journal of Surgical Research
Shamil Aliyev, Halit Eren Taskin, Orhan Agcaoglu, Erol Aksoy, Mira Milas, Allan Siperstein, Eren Berber
BACKGROUND: There is controversy in the literature about whether robotic total thyroidectomy should be performed through unilateral or bilateral axillary incisions. The aim of this study was to perform a detailed critical analysis of the single-incision technique with a focus on postoperative pain, morbidity, and oncologic outcomes. METHODS: Between June 2009 and May 2012, 30 patients underwent robotic neck surgery through a single axillary incision. The perioperative outcomes of 16 patients who underwent robotic total thyroidectomy were compared with 30 consecutive patients undergoing conventional total thyroidectomy...
May 2013: Surgery
Fausto Fama', Cecile Linard, Rosalia Patti, Miles G Berry, Maria Gioffre'-Florio, Arnaud Piquard, Olivier Saint-Marc
We report our prospective experience of short-stay hospitalisation for benign thyroid surgery. Post-operative outcome, complication rate and duration of hospitalisation were evaluated for 200 similar patients with bilateral multi-nodular goitres treated surgically by total thyroidectomy. All subjects gave written informed consent. A short-stay regimen, with discharge within 24 h of admission, was possible in 92.5 %. Fourteen (7 %) were discharged on the second post-operative day and one on the fourth post-operative day...
January 2013: European Archives of Oto-rhino-laryngology
Pier Cristoforo Giulianotti, Pietro Addeo, Nicolas Christian Buchs, Subhashini M Ayloo, Francesco Maria Bianco
BACKGROUND: Thyroid surgery has recently emerged as one of the most promising fields for the application of robotic surgery. We report the results of the first year of experience with a gasless transaxillary thyroidectomy. SUBJECTS AND METHODS: From January 2009 to December 2009, 10 consecutive patients (8 women) underwent robotic thyroidectomy through a gasless transaxillary approach. The median age was 44 years (range, 27-42 years). Eight total and two partial thyroidectomies (one left and one right) were performed using the da Vinci(®) Robotic Surgical System (Intuitive Surgical, Sunnyvale, CA)...
May 2012: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Eitan Podgaetz, Farid Gharagozloo, Farzad Najam, Nader Sadeghi, Marc Margolis, Barbara J Tempesta
OBJECTIVE: : Intrathoracic thyroid goiter is an uncommon condition. Most goiters are found in the superior and anterior mediastinum, which can be removed either through a cervical approach or through a combined cervicotomy and sternotomy approach. Extension of the goiter into the posterior mediastinum is even less common. Transcervival approach to thyroid goiters in the posterior mediastinum can be difficult, necessitating a thoracotomy, with its associated morbidity. METHODS: : A 69-year-old patient underwent robotic assisted minimally invasive procedure, with the daVinci surgical robotic system to excise a thyroid goiter that extended into the posterior mediastinum...
July 2009: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Amit Agarwal, Sudhi Agarwal, Prabhat Tewari, Sushil Gupta, Gyan Chand, Anjali Mishra, Gaurav Agarwal, A K Verma, S K Mishra
BACKGROUND: Huge goiters are common in iodine-deficient endemic regions. They are of concern to the surgeons because of the anticipated risk of difficult dissection and increased chances of surgical complications. Similarly, they are of concern to the anesthesiologists because of anticipated intubation-related difficulties and post-thyroidectomy tracheomalacia. In the present study we aimed to present our experience of managing goiters based on their gross weight, highlighting their clinicopathological profile, perioperative airway-related difficulties, and management of surgical morbidity...
April 2012: World Journal of Surgery
Safina Ali, Changhong Yu, Frank L Palmer, Ian Ganly, Ashok Shaha, Jatin P Shah, Michael W Kattan, Snehal G Patel
OBJECTIVE: To develop statistical prediction tools to select patients for short-stay thyroidectomy based on dynamic quantification of individual risk for postoperative hypocalcemia. DESIGN: Clinical and biochemical factors that could influence postoperative calcium levels were analyzed. A multivariable logistic regression model was used to study the predictive ability of each variable for hypocalcemia. A step-down model reduction selection method was used to rank the predictors according to their predictive accuracy...
November 2011: Archives of Otolaryngology—Head & Neck Surgery
Sang-Wook Kang, Jae Hyun Park, Jun Soo Jeong, Cho Rok Lee, Seulkee Park, So Hee Lee, Jong Ju Jeong, Kee-Hyun Nam, Woong Youn Chung, Cheong Soo Park
PURPOSE: Robotic surgical systems are among the most innovative surgical developments and have radically promoted the use of minimally invasive techniques. Robotic technologies using different approaches have also been applied to thyroid surgery. Recently, the authors described a novel robotic surgical method for thyroid surgery based on a gasless, transaxillary approach (TAA), and have since serially reported on its technical feasibility and safety. Here, the authors report their experience of a consecutive series of 1000 cases treated using robotic thyroidectomy, and demonstrate its use for the surgical management of thyroid cancer...
August 2011: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
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