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Annals of Surgical Oncology

, Volume 23, Issue 5, pp 1440–1445 | Cite as

An Evaluation of Postoperative Complications and Cost After Short-Stay Thyroid Operations

  • Sumana NarayananEmail author
  • Dena Arumugam
  • Steven Mennona
  • Marlene Wang
  • Tomer Davidov
  • Stanley Z. Trooskin
Endocrine Tumors

Abstract

Background

Concern for postoperative complications causing airway compromise has limited widespread acceptance of ambulatory thyroid surgery. We evaluated differences in outcomes and hospital costs in those monitored for a short stay of 6 h (SS), inpatient observation of 6–23 h (IO), or inpatient admission of >23 h (IA).

Methods

We retrospectively reviewed all patients undergoing thyroidectomy from 2006 to 2012. The incidence of postoperative hemorrhage, nerve dysfunction, and hypocalcemia were evaluated, as well as cost data comparing the SS and IO groups.

Results

Of 1447 thyroidectomies, 880 (60.8 %) were performed as SS, 401 (27.7 %) as IO, and 166 (11.5 %) as IA. Fewer patients in the SS group (59 %) underwent total thyroidectomy than IO (73 %) and IA (71 %; p < 0.01), and SS patients had smaller thyroid weights (27.9 g) compared with IO and IA (47.2 and 98.9 g, respectively; p < 0.01). Ten (0.69 %) patients developed hematomas requiring reoperation, five of the ten patients received antiplatelet or anticoagulant therapy perioperatively. Only one patient in the IA group bled within the 6- to 23-h period, and no patients with bleeding who were discharged at 6 h would have benefitted from 23-h observation. Twenty-four (1.66 %) recurrent laryngeal nerve injuries were identified, 16 with temporary neuropraxias. In addition, 24 (1.66 %) patients had symptomatic hypocalcemia, which was transient in 17 individuals. Financial data showed higher payments and lower costs associated with SS compared with IO.

Conclusions

Selective SS thyroidectomy can be safe and cost effective, with few overall complications in patients undergoing more complex operations involving larger thyroids who were admitted to hospital.

Keywords

Total Thyroidectomy Inpatient Admission Multinodular Goiter Short Stay Recurrent Laryngeal Nerve Injury 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Sumana Narayanan
    • 1
    Email author
  • Dena Arumugam
    • 1
  • Steven Mennona
    • 2
  • Marlene Wang
    • 2
  • Tomer Davidov
    • 1
    • 2
  • Stanley Z. Trooskin
    • 1
    • 2
  1. 1.Department of SurgeryRutgers Robert Wood Johnson Medical SchoolNew BrunswickUSA
  2. 2.Rutgers Cancer Institute of New JerseyNew BrunswickUSA

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