Introduction Historically, concerns about complications following parathyroid surgery, such as airway compromise,
bleeding and
hypocalcemia, have precluded its consideration as a short-stay
surgical procedure. Recent advancements in
perioperative care have resulted in several publications demonstrating that
parathyroidectomy can be safely performed as a short-stay procedure. Objectives The aim of the present study was to describe the process of implementing a short-stay protocol focusing on preoperative patient education and postoperative
calcium management for those undergoing surgery for
primary hyperparathyroidism (PHP). Method A retrospective audit of consecutive
parathyroidectomies performed for PHP over the period between 2010 and 2013 was performed. A short-stay protocol (SSP) was introduced focusing on postoperative
calcium management. Results were reaudited over the period between 2013 and 2015. Results Consecutive
parathyroidectomies in 76 patients were included in the study. A total of 42 patients underwent
parathyroidectomy prior to the introduction of the protocol. A total of 26.2% of these patients were symptomatic from
hypercalcemia. A total of 40 out of 42 (95.2%) patients had a biochemical cure. A total of 36 out of 42 (85.7%) cases were due to
parathyroid adenomas. A total of 34 patients underwent surgery following the introduction of the protocol. A total of 13 out of 34 (38.2%) of the patients had symptomatic
hypercalcemia. A total of 33 out of 34 (97.1%) had a biochemical cure. A total of 32 out of 34 (94.1%) cases were due to
parathyroid adenomas. The
length of stay decreased from a median of 3 days (range 2-9 days; mean 3.32) preprotocol to a median of 2 days (range 2-3 days; mean 2.16) postprotocol ( p < 0.0001) with no difference in the 30-day
unplanned readmission rate (4.8 versus 2.9%; p = 0.999). Conclusions The postoperative
length of stay after
parathyroidectomy for PHP can be safely reduced through patient education and by rationalizing postoperative
calcium management without adversely affecting outcomes.