title: Profile of patients with completion thyroidectomy and assessment of their suitability for outpatient surgery.
abstract: OBJECTIVE
  Outpatient thyroid surgery for thyroid lobectomy has been shown to be safe and feasible. The safety of outpatient completion thyroidectomy in patients who have previously undergone thyroid lobectomy has not been extensively evaluated in the medical literature to date. The authors sought to evaluate postoperative complications associated with completion thyroidectomy in their institution to determine if it would be safe and feasible to perform as an outpatient procedure.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary care teaching hospital.
  
  
  METHODS
  Two hundred four consecutive patients, who underwent completion thyroidectomy after previous thyroid lobectomy from January 2000 to June 2010, comprised the study population. Medical records were reviewed for preoperative and postoperative serum calcium levels, preoperative and postoperative fiber-optic laryngoscopic examination of vocal fold mobility, associated comorbidities, length of hospital stay, drain use, seroma or hematoma formation, final thyroid pathology, and postoperative follow-up.
  
  
  RESULTS
  Overall, 9 patients (4.4%) developed postoperative complications, including transient symptomatic hypocalcemia in 4 patients (2.0%), transient laboratory hypocalcemia in 3 patients (1.5%), seroma formation in 1 patient (0.5%), and hematoma development in 1 patient (0.5%). There were no cases with permanent or temporary vocal fold paralysis. No significant difference was found in the overall complication rate before and after 4 hours of observation (P = .50).
  
  
  CONCLUSIONS
  Selected patients who undergo completion thyroidectomy after previous thyroid lobectomy can be safely discharged after 4 hours of postoperative observation with appropriate instructions.
authors.affiliation: Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
authors.forename: Gaosong
authors.initials: G
authors.lastname: Wu
authors.forename: Sara I
authors.initials: SI
authors.lastname: Pai
authors.forename: Nishant
authors.initials: N
authors.lastname: Agrawal
authors.forename: Jeremy
authors.initials: J
authors.lastname: Richmon
authors.forename: Alan
authors.initials: A
authors.lastname: Dackiw
authors.forename: Ralph P
authors.initials: RP
authors.lastname: Tufano
mesh_terms: D000556:Ambulatory Surgical Procedures; D002118:Calcium / Q000097:blood; D015897:Comorbidity; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology; D007828:Laryngoscopy; D007902:Length of Stay; D011183:Postoperative Complications; D011184:Postoperative Period; D057234:Preoperative Period; D012086:Reoperation; D049291:Seroma / Q000209:etiology; D013961:Thyroid Gland / Q000473:pathology; D013965:Thyroidectomy; D014826:Vocal Cord Paralysis / Q000209:etiology; D014827:Vocal Cords / Q000502:physiology
chemical_list: D002118:Calcium