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Int Arch Otorhinolaryngol. 2023 May 16;27(4):e625-e629. doi: 10.1055/s-0042-1758714. eCollection 2023 Oct.
2
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本文引用的文献

1
Adverse events in thyroid surgery: observational study in three surgical units with high volume/year.甲状腺手术中的不良事件:三个高年手术量外科单位的观察性研究。
BMC Surg. 2021 Sep 25;21(1):352. doi: 10.1186/s12893-021-01353-6.
2
Appropriate selection of candidates for outpatient thyroidectomy.门诊甲状腺切除术患者的恰当选择。
Curr Opin Endocrinol Diabetes Obes. 2021 Oct 1;28(5):547-551. doi: 10.1097/MED.0000000000000672.
3
Introducing day case thyroid lobectomy at a tertiary head and neck centre.在一家三级头颈中心开展日间甲状腺叶切除术。
Ann R Coll Surg Engl. 2021 Jul;103(7):499-503. doi: 10.1308/rcsann.2020.7063.
4
Risk Score of Neck Hematoma: How to Select Patients for Ambulatory Thyroid Surgery?颈部血肿风险评分:如何选择门诊甲状腺手术患者?
World J Surg. 2021 Feb;45(2):515-521. doi: 10.1007/s00268-020-05840-4. Epub 2020 Oct 30.
5
Malignancy Rate in Thyroid Nodules with Atypia or Follicular Lesion of Undetermined Significance.具有非典型性或意义未明的滤泡性病变的甲状腺结节的恶性率
Int Arch Otorhinolaryngol. 2020 Apr;24(2):e221-e226. doi: 10.1055/s-0039-1698784. Epub 2020 Jan 28.
6
Day-case thyroid lobectomy parameters at a tertiary referral head and neck centre: a sensitivity and cost analysis.三级转诊头颈部中心日间甲状腺叶切除术的参数:敏感性和成本分析。
Eur Arch Otorhinolaryngol. 2020 Sep;277(9):2527-2531. doi: 10.1007/s00405-020-05921-z. Epub 2020 Apr 3.
7
Outpatient versus inpatient thyroidectomy: A systematic review and meta-analysis.门诊与住院甲状腺切除术:一项系统评价与荟萃分析。
Head Neck. 2018 Jan;40(1):192-202. doi: 10.1002/hed.24934. Epub 2017 Nov 9.
8
Safety of same-day thyroidectomy: meta-analysis and systematic review.当日甲状腺切除术的安全性:荟萃分析与系统评价
Gland Surg. 2017 Aug;6(4):292-301. doi: 10.21037/gs.2017.01.05.
9
2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: What is new and what has changed?2015 年美国甲状腺协会成人甲状腺结节和分化型甲状腺癌患者管理指南:有哪些新内容和变化?
Cancer. 2017 Feb 1;123(3):372-381. doi: 10.1002/cncr.30360. Epub 2016 Oct 14.
10
Ambulatory thyroidectomy: a multistate study of revisits and complications.门诊甲状腺切除术:一项关于复诊和并发症的多州研究。
Otolaryngol Head Neck Surg. 2015 Jun;152(6):1017-23. doi: 10.1177/0194599815577603. Epub 2015 Mar 31.

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.

DOI:10.1055/s-0042-1758714
PMID:39139710
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11321666/
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。