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"Same-day" thyroid surgery: an analysis of safety, cost savings, and outcome.

Abstract
Twenty-three-hour observation or "same-day" thyroid surgery was initiated at our institution for patients with nodular thyroid disease in July 1993. A retrospective review of all patients with nodular thyroid disease who underwent same-day thyroid surgery was performed to determine the safety and cost effectiveness of this approach. Eighty consecutive patients with nodular thyroid disease underwent thyroidectomy, followed by < or = 23 hours of observation in 71 (88%) and a planned hospital admission in 9 (12%) patients. Hospital admission preceded thyroidectomy in four patients (5%) because of transient ischemic attacks (one), airway obstruction (one), pulmonary disease (one), and suppurative thyroiditis (one). Five patients (6%) had a planned postoperative admission because of concominant modified neck dissection (two), median sternotomy (two), or soft tissue tumor resection (one). Of the 71 patients who underwent same-day thyroid surgery, 47 had near-total or total thyroidectomy, 20 lobectomy, and 4 completion thyroidectomy. Morbidity consisted of hematoma in one, recurrent laryngeal nerve paresis in two, and transient hypocalcemia in eight patients. Only 1 of the 71 patients required subsequent hospitalization for an anxiety attack. There was no mortality. Twenty-three-hour observation was associated with a 32 per cent and a 47 to 56 per cent reduction in cost for unilateral and bilateral thyroidectomy, respectively. Same-day thyroid surgery is a safe and costeffective approach for patients with nodular thyroid disease.
AuthorsC R McHenry
JournalThe American surgeon (Am Surg) Vol. 63 Issue 7 Pg. 586-9; discussion 589-90 (Jul 1997) ISSN: 0003-1348 [Print] United States
PMID9202531 (Publication Type: Journal Article)
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Surgical Procedures (economics, standards)
  • Cost Savings
  • Female
  • Hospital Costs
  • Humans
  • Male
  • Middle Aged
  • Ohio
  • Retrospective Studies
  • Thyroid Diseases (surgery)
  • Thyroidectomy (economics, methods)
  • Treatment Outcome

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