Outpatient hemithyroidectomy for benign thyroid disease

Dan Med J. 2020 Sep 29;67(10):A03200151.

Abstract

Introduction: Hemithyroidectomy for benign thyroid disease has traditionally been considered an inpatient procedure due to concerns about post-operative complications, in particular the risk of post-thyroidectomy bleeding (PTB). Hemithyroidectomy in an outpatient setting has not yet been evaluated in a Danish context. This study aimed to evaluate outpatient compared to inpatient hemithyroidectomy in selected patients (no suspicion of malignancy, lesser-than 100 ml lobe, American Society of Anesthesiologists class I or II and no anticoagulation therapy) to investigate the safety of the procedure.

Methods: This cohort study was conducted between June 2014 and June 2019 in a Danish regional hospital and included all hemithyroidectomy patients. Data were obtained retrospectively from medical records. The primary outcome was PTB, and secondary outcomes included nerve injury, infection, perioperative drain placement, reintervention and unplanned hospital contacts.

Results: Hemithyroidectomy was performed in 229 patients. For 137 patients, the procedure was planned in an outpatient setting; and among these, 124 patients (91%) were completed as planned. None of the patients in either the outpatient or inpatient setting experienced PTB. In the outpatient group, 1.5% had permanent nerve injury of the recurrent nerve and 0.7% had a superficial wound infection which was treated with oral antibiotics.

Conclusions: Hemithyroidectomy for benign thyroid disease is safe to perform in an outpatient setting for a selected patient group.

Funding: none.

Trial registration: not relevant.

MeSH terms

  • Cohort Studies
  • Humans
  • Outpatients
  • Retrospective Studies
  • Thyroid Diseases* / surgery
  • Thyroidectomy*