['Same-day' thyroid surgery. Results after 805 thyroidectomies in a fast-track program].
BACKGROUND
The aim of this study was to analyze the validity of a fast-track surgery program with less than 24-hour admission for all thyroid disease treated in an endocrine surgery unit.


METHODS
Between January 2000 and January 2006, 805 consecutive patients underwent thyroid surgery in a fast-track program. Data on type of disease, procedure, operating time, length of hospital stay, postoperative morbidity, and the number of reinterventions and readmissions were gathered.


RESULTS
After a minimum follow-up of 6 months, transitory hypocalcemia occurred in 4.8%, permanent hypocalcemia in 0.2%, transitory dysphonia in 2.5%, and permanent dysphonia in 1.1%. Only 7 patients required emergency reintervention in the first 6 hours after surgery, in all patients due to hemorrhage. Most of these complications occurred in patients undergoing surgery for hyperthyroidism or in those undergoing total thyroidectomy with modified radical neck dissection. Most patients were discharged within 24 hours with a mean length of hospital stay of 23.9 hours, excluding patients who underwent cervical lymphadenectomy. There were only three readmissions, all of which were due to correction of symptomatic hypocalcemia.


CONCLUSIONS
Except for total thyroidectomy with modified radical neck dissection due to cancer, all thyroid surgery can be performed in a fast-track program with less than 24-hour admission, within a specialized endocrine surgery unit.
Ortega
Joaquín
J
Unidad de Cirugía Endocrina y de la Obesidad, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario, Blasco Ibáñez 17, 46010 Valencia, Spain. joaquin.ortega@uv.es
Cassinello
Norberto
N
Lledó
Salvador
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology; D008875:Middle Aged; D011183:Postoperative Complications; D013965:Thyroidectomy / Q000379:methods*; D013997:Time Factors; D014832:Voice Disorders / Q000209:etiology