Outpatient Thyroid Surgery in a Low-Surgical Volume Hospital.

BACKGROUND: To determine the safety and outcome of outpatient thyroid surgery in a small low-surgical volume hospital. To evaluate clinical and social factors that may prohibit outpatient thyroid surgery.

METHODS: Retrospective analysis of all thyroid surgery performed at a low-surgical volume hospital from August 2006 to July 2014. One-hundred and sixty patients underwent thyroid surgery during the study period. Electronic medical records were reviewed for all patients. Data collection included demographic information, extent of thyroid surgery, length of hospital stay, laboratory/pathology results, co-morbidities, and complications.

RESULTS: Of the 160 patients who underwent thyroid surgery, 109 (68.1%) were discharged on the day of surgery. Forty-three patients (26.9%) were admitted for 23-h observation and eight patients (5%) required full admission (longer than 24 h). Sixty-one patients (38.1%) underwent a total thyroidectomy, while 99 patients (61.9%) underwent a hemithyroidectomy. Complications included four temporary recurrent laryngeal nerve (RLN) injuries (2.5% patients/1.8% of total RLN at risk), one permanent RLN injury (0.63% patients/0.45% of total RLN as risk), one temporary bilateral RLN injury (0.63%), two delayed hematomas (1.3%), and eight cases of transient hypocalcemia (5%).

CONCLUSION: Outpatient thyroid surgery can be performed safely in a low-surgical volume center. Reasons for a longer stay include clinical as well as social factors.