Day-case and short-stay surgery: the future for thyroidectomy?

Day-case and short-stay thyroid surgery is carried out routinely around the world. In the UK longer postoperative stay is usually advocated to circumvent/identify potentially catastrophic complications following thyroidectomy. In the current climate of the National Health Service with focus on patient-centred service, reduced hospital stay and cost cutting, we conducted a review to provide a comprehensive assessment of day-case and short-stay thyroidectomy. A systematic electronic literature search using MEDLINE, Ovid, Embase, PubMed and Cochrane databases revealed 22 original studies that met our inclusion criteria. Generally studies demonstrated encouraging results regarding the feasibility of these approaches. Complication rates appeared equivocal to traditional longer stay thyroidectomy and only one patient died. The majority of life-threatening complications occurred in the immediate postoperative period. Of concern, some late haemorrhage has been documented at 5 days postsurgery. Complication rates following day-case/short-stay thyroid surgery appears comparable with inpatient thyroidectomy. Further study is required to determine whether this approach is truly safe.