Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Am J Surg. 2018 Nov;216(5):985-989. doi: 10.1016/j.amjsurg.2018.07.002. Epub 2018 Jul 10.
Outpatient thyroidectomy is increasingly performed. Thyroidectomy for Graves' disease, however, has greater risk of periprocedural complications, limiting use of same-day procedures. We sought to demonstrate that these patients may be managed with ambulatory surgery.
The experience of one endocrine surgeon with thyroidectomy for Graves' was examined from January 2016-November 2017. Forty-one patients met criteria. Patient demographics, perioperative parameters, and postoperative outcomes including emergency department utilization and readmission were recorded.
Mean age was 31.5 ± 17.0 years, with 80% females. Mode ASA score was 3, and median operative time was 77 minutes (43-132). Complications included transient hypocalcaemia in 12%, and temporary laryngeal nerve palsy in 9.7%, with no permanent complications. Two patients were admitted immediately postoperatively for non-medical reasons. Thirty-day emergency rdepartment visits were noted in 9.7%, with subsequent readmission of 7%.
Outpatient total thyroidectomy is safe and effective with acceptable morbidity in the Graves' patient.
越来越多的甲状腺切除术是在门诊进行的。然而，甲状腺机能亢进症的甲状腺切除术有更大的围手术期并发症风险，限制了当日手术的应用。我们试图证明这些患者可以通过门诊手术来管理。
从 2016 年 1 月至 2017 年 11 月，研究了一位内分泌外科医生治疗格雷夫斯病的甲状腺切除术经验。符合标准的 41 名患者。记录了患者的人口统计学资料、围手术期参数和术后结果，包括急诊室的利用情况和再入院情况。
平均年龄为 31.5±17.0 岁，80%为女性。ASA 评分中位数为 3，中位手术时间为 77 分钟（43-132）。并发症包括 12%的短暂性低钙血症和 9.7%的暂时性喉返神经麻痹，无永久性并发症。两名患者因非医疗原因在术后立即住院。9.7%的患者在 30 天内急诊就诊，随后有 7%的患者再次入院。
在格雷夫斯病患者中，门诊全甲状腺切除术是安全有效的，且发病率可接受。
