Ambulatory thyroidectomy: A paradigm shift in surgical safety and patient-centered care

IF 2.3 4区医学 Q2 SURGERY

Journal of Visceral Surgery Pub Date : 2026-08-01 Epub Date: 2026-05-21 DOI:10.1016/j.jviscsurg.2026.04.001

Pierre Puygrenier, Martina Bertolami, Séverine Noullet, Gaelle Godiris-Petit, Ariola Hasani, Sebastien Gaujoux, Fabrice Menegaux, Nathalie Chereau

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引用次数: 0

Abstract

Introduction

Despite longstanding concerns regarding life-threatening postoperative complications such as cervical hematoma, recent guidelines endorse ambulatory thyroidectomy as a safe and feasible option when performed under strict selection and monitoring. This study evaluated the safety and feasibility of ambulatory thyroidectomy in a high-volume endocrine surgery center.

Methods

All patients undergoing ambulatory thyroidectomy between May 1st, 2018, and December 31st, 2024 were retrospectively analyzed. Studied outcomes included hematoma, hypocalcemia, recurrent laryngeal nerve (RLN) injury, infection, and unplanned admission. One-step total thyroidectomy was not eligible for ambulatory care.

Results

A total of 3047 adult patients (77% female; mean age 48.5 ± 14 years) were included: 86% underwent lobectomy, 12% completion thyroidectomy, and 2% isthmectomy. In all, 954 (31%) were performed for malignant diseases. The proportion of ambulatory thyroidectomies among all partial thyroidectomy procedures increased from 7% in 2018 to 32% in 2024. Complication rates were low: hematoma (0.8%), including those requiring reoperation (19/23; 82.6%), transient RLN palsy (1.9%), symptomatic hypocalcemia (1.1%), permanent hypoparathyroidism (0.3%), and wound infection (0.2%).

Conclusion

Ambulatory thyroidectomy can be safely integrated into routine surgical practice when conducted within a structured perioperative pathway emphasizing meticulous patient selection, extended postoperative observation, and comprehensive patient education.

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门诊甲状腺切除术：手术安全性和以患者为中心的护理模式的转变。

导论：尽管长期以来对危及生命的术后并发症（如宫颈血肿）的担忧，但最近的指南支持在严格选择和监测下进行门诊甲状腺切除术是一种安全可行的选择。本研究评估了在大容量内分泌外科中心进行门诊甲状腺切除术的安全性和可行性。方法：回顾性分析2018年5月1日至2024年12月31日所有行门诊甲状腺切除术的患者。研究结果包括血肿、低钙血症、喉返神经（RLN）损伤、感染和意外入院。一步甲状腺全切除术不适合门诊护理。结果：共纳入3047例成人患者（女性77%，平均年龄48.5±14岁）：86%行肺叶切除术，12%完成甲状腺切除术，2%胸骨切除术。其中954例（31%）为恶性疾病。门诊甲状腺切除术在所有甲状腺部分切除术中的比例从2018年的7%上升到2024年的32%。并发症发生率低：血肿（0.8%），包括需要再手术的（19/23;82.6%），短暂性RLN麻痹（1.9%），症状性低钙血症（1.1%），永久性甲状旁腺功能低下（0.3%）和伤口感染（0.2%）。结论：门诊甲状腺切除术可以安全地纳入常规手术实践，在结构化的围手术期路径下进行，强调精心的患者选择，延长术后观察和全面的患者教育。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Visceral Surgery SURGERY-

CiteScore

2.00

自引率

9.50%

发文量

108

审稿时长

>12 weeks

期刊介绍： The Journal of Visceral Surgery (JVS) is the online-only, English version of the French Journal de Chirurgie Viscérale. The journal focuses on clinical research and continuing education, and publishes original and review articles related to general surgery, as well as press reviews of recently published major international works. High-quality illustrations of surgical techniques, images and videos serve as support for clinical evaluation and practice optimization. JVS is indexed in the main international databases (including Medline) and is accessible worldwide through ScienceDirect and ClinicalKey.