Short Stay Thyroid Surgery: Can We Replicate the Same in Low Resource Setting?

Naval Bansal,Kamal Kishore,Ashok Kumar Verma,Sanjay Kumar Yadav,Saroj Kanta Mishra,Amit Agarwal,Gaurav Agarwal,Gyan Chand,Anjali Mishra

doi:10.1155/2018/4910961

Abstract

Introduction The concept of short stay thyroidectomy has been tested and in practice in the developed world; the same has not been replicated in countries with limited resources due to lack of organized healthcare system. So, in this study, we tried to analyze if short stay thyroid surgery can be performed in a cost-effective way in developing countries and also if the endocrine surgical trainee can deliver these services safely. Methods The study was conducted prospectively from January 2013 to July 2014, at Department of Endocrine Surgery, SGPGIMS, Lucknow, India. Study group included patients undergoing short stay hemithyroidectomy whereas matched patients who qualified for inclusion criteria but did not undergo short stay surgery due to various reasons constituted control group. Outcome in both the groups was compared in terms of complication rates, cost benefit, and patient satisfaction. Subgroup analysis was also done for trainee versus consultant performed short stay thyroid surgery. Results A total of 439 patients with surgical thyroid disorders were evaluated at our institute during the study period and out of these 110 patients (58 cases and 52 controls) fulfilled the inclusion criteria. Younger patients with low socioeconomic status who were paying out of pocket were found to be more inclined to short stay thyroid surgery. There was no significant difference between the two groups in terms of postanesthetic discharge score (PADS), complication rates, and patients satisfaction; however there was significant reduction (p <0.001) in hospital cost in short stay group. In subgroup analysis, procedure time was more in trainee performed surgeries; however there was no significant difference in terms of mean PADS and complication rates. Conclusion Short stay thyroidectomy can provide a better cost-effective alternative to conventional thyroidectomy in patients undergoing thyroid surgery and can be safely performed by endocrine surgical trainees even in a low resource setting.

Highlights

The concept of short stay thyroidectomy has been tested and in practice in the developed world; the same has not been replicated in countries with limited resources due to lack of organized healthcare system
Study group included patients undergoing short stay thyroidectomy and control group included matched patients who qualified for inclusion criteria but did not undergo short stay surgery due to various reasons
Outcome in both groups was compared in terms of complication rates, cost benefit, and patient satisfaction

Summary

Introduction

The concept of short stay thyroidectomy has been tested and in practice in the developed world; the same has not been replicated in countries with limited resources due to lack of organized healthcare system. In this study, we tried to analyze if short stay thyroid surgery can be performed in a cost-effective way in developing countries and if the endocrine surgical trainee can deliver these services safely. Study group included patients undergoing short stay hemithyroidectomy whereas matched patients who qualified for inclusion criteria but did not undergo short stay surgery due to various reasons constituted control group Outcome in both the groups was compared in terms of complication rates, cost benefit, and patient satisfaction. Short stay thyroidectomy can provide a better cost-effective alternative to conventional thyroidectomy in patients undergoing thyroid surgery and can be safely performed by endocrine surgical trainees even in a low resource setting. In this study, we aim to analyze if short stay thyroid surgery can be replicated in low resource setting in a cost-effective way and if the endocrine surgical trainees can deliver these services safely

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Conclusion