[Length of hospital stay and complications in thyroid surgery. Our experience].
Length of hospital stays for thyroid surgery has decreased significantly over the last years. Hypoparathyroidism is one of the main obstacles to short-stay hospitalization. The aim of this study was to evaluate length of hospital stay in our experience, its relationship with complications observed and feasibility of short-stay hospitalization regimen. Between September 2002 and December 2005, 932 patients underwent total thyroidectomy in our institution. Serum calcium and phosphorus values were obtained at 6 hours after operation and on postoperative day 1 and 2. Discharge was possible on the morning of the first postoperative day in 2 patients (0.2%), the second day in 687 (73.7%), third day in 167 (17.9%), fourth in 44 (4.7%), fifth in 22 (2.4%), after the fifth in 10 (1.1%). Complications observed were hypoparathyroidism in 393 patients (42.1%), neck hematoma in 12 (1.3%), bilateral recurrent nerve palsy in 5 (0.5%), unilateral recurrent nerve palsy in 4 (0.4%), glottic hemorrhagic edema in 1 (0.1%) and foreign body granuloma and/or fistula in 5 (0.5%). Hypocalcemia was observed on post-operative day 1 in 338 patients (86%), on day 2 in 50 (12.72%) and on day 3 in 5 (1.27%). Serum calcium and phosphorus determination 6 hours after operation and on postoperative day 1 permits an early treatment of hypocalcemia and to shorten length of hospital stay. A normal serum calcium level on postoperative day 1 lets suppose an easy discharge on the second. Earlier discharge is to be reserved to selected patients and not always meets their favour.
Calò
Pietro Giorgio
PG
Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università degli Studi di Cagliari, Policlinico Universitario.
Tatti
Alberto
A
Farris
Stefania
S
Nicolosi
Angelo
A
D002118:Calcium / Q000097:blood; D005240:Feasibility Studies; D005260:Female; D005931:Glottis; D015745:Granuloma, Foreign-Body / Q000209:etiology; D006406:Hematoma / Q000209:etiology; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology; D007011:Hypoparathyroidism / Q000209:etiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009333:Neck; D010758:Phosphorus / Q000097:blood; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000097:blood / Q000150:complications* / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects*; D014826:Vocal Cord Paralysis / Q000209:etiology
D010758:Phosphorus; D002118:Calcium