Safety of Daycase Thyroid and Parathyroid Surgery with Developments in Education and Training in addition to Patient Information Leaflets.

Abstract

Abstract Introduction BAETS recently reviewed daycase thyroid surgery in the UK through a debate and webinar; and changed the society's position statement in support of daycase thyroid procedures. Post-thyroidectomy haemorrhage remains a concern. This Endocrine Surgical Unit published data (2015 & 2017) regarding our daycase thyroid/parathyroid surgery since 2005. The practice has developed in numbers, patient information given and safety protocols. Method We reviewed our outcomes from the last 4 years and developed a Patient Information Leaflet that reflects the new BAETS position, outlining what to expect from surgery, what to look out for in the post-operative period, and what action to take should complications arise. This is used in conjunction with our stringent protocol for daycase thyroid/parathyroid surgery (exclusion criteria include: children; bilateral/redo surgery; sternotomy; ASA 3&4; living alone; >45 minutes from hospital). Results Review of cases performed between June 2017 and May 2021 confirmed 25.2% (81/322) of procedures were daycase and without complication (28 (all lobectomies)/160 thyroid and 53/162 parathyroid procedures, respectively). Protocol improvements include an ‘emergency pack’ of wound-opening equipment staying with the patient throughout their stay; training for Ward and Emergency Department staff in opening neck incisions for postoperative haemorrhage (SCOOP video, posters displayed in ward areas and within the emergency pack, provision of instruments within the Emergency Department). Conclusion Outcomes demonstrate safety of daycase thyroid and parathyroid surgery in a UK hospital within our protocol. Refinements to our protocol, staff education, instrument availability and patient information leaflets aim to ameliorate concerns about daycase thyroid/parathyroid surgery for patients and staff.