To admit or not to admit? Experience with outpatient thyroidectomy for Graves’ disease in a high-volume tertiary care center

Abstract

BackgroundOutpatient thyroidectomy is increasingly performed. Thyroidectomy for Graves' disease, however, has greater risk of periprocedural complications, limiting use of same-day procedures. We sought to demonstrate that these patients may be managed with ambulatory surgery. MethodsThe experience of one endocrine surgeon with thyroidectomy for Graves' was examined from January 2016–November 2017. Forty-one patients met criteria. Patient demographics, perioperative parameters, and postoperative outcomes including emergency department utilization and readmission were recorded. ResultsMean age was 31.5 ± 17.0 years, with 80% females. Mode ASA score was 3, and median operative time was 77 minutes (43–132). Complications included transient hypocalcaemia in 12%, and temporary laryngeal nerve palsy in 9.7%, with no permanent complications. Two patients were admitted immediately postoperatively for non-medical reasons. Thirty-day emergency rdepartment visits were noted in 9.7%, with subsequent readmission of 7%. ConclusionsOutpatient total thyroidectomy is safe and effective with acceptable morbidity in the Graves' patient.