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单侧甲状腺叶切除术作为日间手术:一项关于安全性和成本效益的横断面研究及文献综述

Unilateral Thyroid Lobectomy as Day Care Procedure: A Cross Sectional Study with Literature Review on the Safety and Cost Effectiveness.

作者信息

Mughal Ainulakbar, Vardag Abdul Basit Shah, Deewani Muhammad Hammad, Wasif Muhammad, Mughal Marhaba, Awan Sohail, Unar Ambreen

机构信息

Section of Otolaryngology, Head-Neck Surgery, Aga Khan University Hospital, Karachi, Pakistan.

出版信息

Int Arch Otorhinolaryngol. 2023 May 16;27(4):e625-e629. doi: 10.1055/s-0042-1758714. eCollection 2023 Oct.

Abstract

Thyroid nodules are common globally in almost one fifth of the adult population. The gold standard treatment for thyroid nodule is thyroid lobectomy or total thyroidectomy depending upon the diagnosis. Thyroidectomy has a few known complications but, as per the ATA consensus statement, it is a safe surgery to be done as a day care procedure.  To access the feasibility and safety of thyroid lobectomy as a day care surgery and its effect on decreasing overall financial burdens.  This retrospective chart review was done from 2006 to 2022. A total of 736 patients underwent thyroid lobectomy among which only 56 were done as day care surgery. Data analysis was done using the IBM SPSS Statistics for Windows, Version 23.0 (IBM Corp., Armonk, NY, USA).  A total of 40% of the population was male. The mean age of the study population was 42 years. Bethesda II was the most encountered diagnosis, with a rate of 69%. The majority of patients were discharged after 6 hours of postoperative observation. The only complication encountered was seroma, which was seen in two patients.  Thyroid lobectomy appears to be a safe procedure with a drastic difference in overall cost as a day care procedure. We recommend switching the practice of inpatient thyroid lobectomy to a day care procedure in carefully selected candidates. The major hurdle in day care lobectomy can be approval from insurance.

摘要

甲状腺结节在全球范围内都很常见,几乎占成年人口的五分之一。甲状腺结节的金标准治疗方法是根据诊断结果进行甲状腺叶切除术或全甲状腺切除术。甲状腺切除术有一些已知的并发症,但根据美国甲状腺协会(ATA)的共识声明,它作为日间手术是一种安全的手术。

为了评估甲状腺叶切除术作为日间手术的可行性和安全性及其对减轻总体经济负担的影响。

这项回顾性病历审查是在2006年至2022年期间进行的。共有736例患者接受了甲状腺叶切除术,其中只有56例是作为日间手术进行的。使用IBM SPSS Statistics for Windows 23.0版(IBM公司,美国纽约州阿蒙克)进行数据分析。

研究人群中40%为男性。研究人群的平均年龄为42岁。贝塞斯达二级诊断最为常见,发生率为69%。大多数患者在术后观察6小时后出院。仅发现两例患者出现血清肿这一并发症。

甲状腺叶切除术作为一种日间手术,似乎是一种安全的手术,且总体费用有显著差异。我们建议在经过精心挑选的患者中,将住院甲状腺叶切除术的做法改为日间手术。日间甲状腺叶切除术的主要障碍可能是保险批准。

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