OUTPATIENT THYROID AND PARATHYROID SURGERY - A PROSPECTIVE-STUDY OF FEASIBILITY, SAFETY, AND COSTS

Background. The purpose of this study was to determine feasibility, sa fety, and cost savings of outpatient thyroid and parathyroid surgery. Methods. Consecutive unselected patients undergoing thyroid and parath yroid operations by two surgeons with a special interest in endocrine surgery were studied prospectively. Results. One-hundred patients unde rwent operation, 61 as outpatients and 39 as inpatients. Outpatients i ncluded those undergoing thyroid lobectomy (39), total thyroidectomy ( 10), total thyroidectomy with parathyroidectomy (1), total thyroidecto my with modified neck dissection (1), and parathyroidectomy (10). Inpa tients included those undergoing thyroid lobectomy (15), total thyroid ectomy (8), total thyroidectomy with neck, dissection (4), removal of substernal goiter (2), and parathyroidectomy (10). The average age of inpatients was slightly higher than that of outpatients (p < 0.05). Av erage hospital cost for outpatients was $1991 +/- $279 (range, $1594 t o $2783) and for inpatients it was $2875 +/- 615 (range, $2031 to $421 6), p < 0.001. Reasons for admission included extent of surgery (6), n ausea (5), oversedation (4), urinary retention (2), inadequate home he lp (6) long travel time (2), patient preference (9), and medical reaso ns (5). No outpatients subsequently required admission. Conclusions. O utpatient thyroid and parathyroid surgery can be feasible and safe and resulted in a 30% savings in hospital costs. After extensive operatio ns patients continue to require admission for postanesthetic complicat ions, social reasons, or presence of serious comorbid disease.