Materazzi G, Dionigi G, Berti P, Rago R, Frustaci G, Docimo G, Puccini M, Miccoli P
Dipartimento di Chirurgia, Università di Pisa, Pisa, Italy.
Eur Surg Res. 2007;39(3):182-8. doi: 10.1159/000100904. Epub 2007 Mar 16.
Short-stay thyroid surgery (<24 h hospital stay) is becoming increasingly popular but some potentially lethal complications are considered strong arguments against shortening hospitalization after thyroidectomy. The authors reviewed the data of 1,571 patients undergoing one-day thyroid surgery over a 3-year period to determine safety and patient satisfaction. There were 1,244 females and 327 males. Mean age was 43 years. Patient satisfaction was evaluated by a questionnaire given on discharge, while post-discharge surgical recovery was analyzed by the PSR scale. Total thyroidectomy was performed in 1,119 patients (71%), hemithyroidectomy in 450 (29%), isthmusectomy in 2. Morbidity occurred in 152 patients (9.6%). Surgical complications were transient hypocalcemia in 112 cases and permanent hypoparathyroidism in 3; monolateral transient nerve palsy occurred in 10 cases, bilateral in 3; definitive monolateral recurrent palsy in 4 cases. Bleeding requiring re-intervention occurred in 10 cases, wound complications in 5 cases, and intraoperative tracheal lesion in 1 patient. Among complicated patients, 129 (84.8%) were treated after discharge as outpatients. Conversion to inpatient treatment occurred in 28 patients (1.7%) (25 for surgical reasons). Four patients (0.2%) required hospital readmission. Patients were very satisfied in 84.2%, satisfied in 9.5%, poorly satisfied in 4.3%, completely unsatisfied in 2%. Postoperative recovery mean score by PSR scale resulted in 85.14% (0-100%). Our results confirm that the one-day surgery model is safe, effective, and highly agreeable in patients undergoing surgery for thyroid disease.
短期甲状腺手术(住院时间<24小时)越来越普遍,但一些潜在的致命并发症被视为反对甲状腺切除术后缩短住院时间的有力论据。作者回顾了1571例患者在3年期间接受一日甲状腺手术的数据,以确定安全性和患者满意度。其中女性1244例,男性327例。平均年龄为43岁。出院时通过问卷调查评估患者满意度,同时通过PSR量表分析出院后的手术恢复情况。1119例患者(71%)行全甲状腺切除术,450例(29%)行半甲状腺切除术,2例行峡部切除术。152例患者(9.6%)出现并发症。手术并发症包括112例短暂性低钙血症和3例永久性甲状旁腺功能减退;10例出现单侧短暂性神经麻痹,3例双侧出现;4例出现明确的单侧喉返神经麻痹。10例患者需要再次干预出血,5例出现伤口并发症,1例患者术中出现气管损伤。在出现并发症的患者中,129例(84.8%)出院后作为门诊患者接受治疗。28例患者(1.7%)转为住院治疗(25例因手术原因)。4例患者(0.2%)需要再次入院。84.2%的患者非常满意,9.5%的患者满意,4.3%的患者满意度差,2%的患者完全不满意。PSR量表术后恢复平均得分为85.14%(0-100%)。我们的结果证实,一日手术模式对于接受甲状腺疾病手术的患者是安全、有效且高度适宜的。