门诊甲状腺切除术：这是一种安全合理的选择吗？
Outpatient thyroidectomy: is it a safe and reasonable option?
机构信息
Department of General Surgery, Legacy Good Samaritan Hospital, Portland, OR, USA.
出版信息
Am J Surg. 2011 May;201(5):565-8. doi: 10.1016/j.amjsurg.2011.01.023.
BACKGROUND
Outpatient surgery is cost effective and convenient. The aim of this study was to determine the safety and feasibility of outpatient thyroidectomy.
METHODS
Retrospective review was performed of all thyroidectomy patients from a tertiary care center between January 2004 and March 2010.
RESULTS
One hundred forty-eight patients met the inclusion criteria. Subtotal and hemithyroidectomies (n = 79) were compared against completion and total thyroidectomies (n = 72). Nine total thyroidectomy patients (12.5%) required unplanned overnight admission, compared with 4 hemithyroidectomy patients (5.1%) (P = .15). The majority were admitted for pain and nausea control. Overnight admissions were highest among men (32% vs 5%, P = .002) and patients with Graves' disease (36% vs 6%, P = .003). Postoperative complications occurred in 6 total thyroidectomy patients (8.3%) and 3 hemithyroidectomy patients (3.8%) (P = .31). Only 4 patients (2.6%) required readmission for complications. There were no deaths.
CONCLUSIONS
Outpatient thyroidectomy performed by an experienced surgeon is safe and feasible. Men and patients with Graves' disease have a higher probability of requiring postoperative admission.
背景
门诊手术具有成本效益和方便的特点。本研究旨在确定门诊甲状腺切除术的安全性和可行性。
方法
对 2004 年 1 月至 2010 年 3 月期间一家三级护理中心的所有甲状腺切除术患者进行回顾性分析。
结果
148 名患者符合纳入标准。甲状腺次全切除术和甲状腺半切除术（n = 79）与甲状腺全切除术和甲状腺全切除术（n = 72）进行了比较。9 名甲状腺全切除术患者（12.5%）需要计划外过夜住院，而 4 名甲状腺半切除术患者（5.1%）需要计划外过夜住院（P =.15）。大多数患者因疼痛和恶心控制而入院。男性（32%比 5%，P =.002）和格雷夫斯病患者（36%比 6%，P =.003）的过夜住院率最高。6 名甲状腺全切除术患者（8.3%）和 3 名甲状腺半切除术患者（3.8%）发生术后并发症（P =.31）。仅 4 名患者（2.6%）因并发症需要再次入院。无死亡病例。
结论
由经验丰富的外科医生进行的门诊甲状腺切除术是安全可行的。男性和患有格雷夫斯病的患者更有可能需要术后住院治疗。
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