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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 1999 August;12(4):263-6
One-day surgery in thyroid surgery. A feasibility study
Tartaglia F., Stocco F., Mastropietro T., Scueglia M., Marchesi M., Biffoni M., Nuccio G., Bernardini E., Campana F. P.
Background and aim. The authors examine a series of 1227 operations involving thyroid pathology in order to identify patients who could have been treated using a one-day surgery regime and discharged <24 hours after the operation.
Methods. A number of qualitative (diagnosis, presence or otherwise of thyroid hyperfunction, development of paresthesia or tetanic crises) and quantitative parameters were analysed (preoperative calcemia and phosphoremia, postoperative values on day 1, 2, 3, etc. and the percentage change of calcium and phosphorus between preoperative levels and day 1). The significant correlations with dischargeability were analysed using inferential statistical methods. The authors also attempted to construct a statistical model to foresee the onset of hypocalcemic symptoms on the basis of calcium and phosphorus values before surgery and on day 1.
Results. The results of this study show that patients undergoing thyroid lobectomy can certainly benefit from early discharge. The model obtained was clinically inapplicable to patients undergoing total thyroidectomy, although it was relatively precise from a statistical point of view.
Conclusions. In the absence of reliable prognostic elements, the authors conclude that one-day surgery should be limited to patients undergoing lobectomy and patients undergoing total thyroidectomy for non-hyperthyreosic benign pathologies that can be monitored at home by a doctor or expert paramedical personnel.