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单一学术机构门诊全甲状腺切除术及甲状腺切除完成术的六年经验

Six-Year Experience of Outpatient Total and Completion Thyroidectomy at a Single Academic Institution.

作者信息

Frank Ethan, Park Joshua, Simental Alfred, Vuong Christopher, Lee Steve, Filho Pedro Andrade, Kwon Daniel, Liu Yuan

出版信息

Am Surg. 2017 Apr 1;83(4):381-384.

Abstract

Outpatient thyroidectomy has become slowly accepted with various published reports predominantly examining partial or subtotal thyroidectomy. Concerns regarding the safety of outpatient total and completion thyroidectomy remain, especially with regard to vocal fold paralysis, hypocalcemia, and catastrophic hematoma. We aimed to evaluate the safety of outpatient thyroid surgery in a large cohort by retrospectively comparing outcomes in those who underwent outpatient (n = 251) versus inpatient (n = 291) completion or total thyroidectomy between February 2009 and February 2015. Outpatient completion and total thyroidectomy had lower rates of temporary hypocalcemia (6% vs 24.4%; P < 0.001) and no significant difference in rates of return to emergency department (1.2% vs 1.4%), hematoma formation (0.8% vs 0.7%), temporary (2% vs 4.1%) or permanent (0.4% vs 0.7%) vocal fold paralysis, or permanent hypocalcemia (0.4% vs 0%) compared with the inpatient group. Outpatients requiring calcium replacement had shorter duration of postoperative calcium supplementation (44.4 ± 59.3 days vs 63.3 ± 94.4 days; P < 0.001). Our data demonstrate similar safety in outpatient and inpatient total and completion thyroidectomy.

摘要

门诊甲状腺切除术已逐渐被接受,各种已发表的报告主要研究部分或次全甲状腺切除术。对于门诊全甲状腺切除术和再次甲状腺切除术的安全性仍存在担忧,尤其是在声带麻痹、低钙血症和灾难性血肿方面。我们旨在通过回顾性比较2009年2月至2015年2月期间接受门诊手术(n = 251)与住院手术(n = 291)的再次或全甲状腺切除术患者的结局,来评估一大群患者中行门诊甲状腺手术的安全性。与住院组相比,门诊再次和全甲状腺切除术的暂时性低钙血症发生率较低(6%对24.4%;P < 0.001),返回急诊科的发生率(1.2%对1.4%)、血肿形成率(0.8%对0.7%)、暂时性(2%对4.1%)或永久性(0.4%对0.7%)声带麻痹率或永久性低钙血症发生率(0.4%对0%)无显著差异。需要补充钙剂的门诊患者术后钙剂补充持续时间较短(44.4±59.3天对63.3±94.4天;P < 0.001)。我们的数据表明门诊和住院全甲状腺切除术及再次甲状腺切除术的安全性相似。

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