Ambulatory endoscopic thyroidectomy via a unilateral-axillary approach has an acceptable safety profile for thyroid nodule.

BACKGROUND

To compare the safety, efficacy, and economic outcomes of ambulatory with inpatient gasless trans-axillary endoscopic unilateral thyroidectomy (GTEUT).

METHODS

Data were collected from patients who underwent GTEUT in the day surgery or inpatient wards of Xiangya Hospital, Central South University, between January 1, 2021, and January 1, 2024. All surgeries were performed by the same experienced surgical team, using identical inclusion and exclusion criteria.

RESULTS

A total of 458 patients were included in the study, with 322 in the ambulatory GTEUT group and 136 in the inpatient GTEUT group. The overall incidence of postoperative complications was lower in the ambulatory GTEUT group (7.76%) compared to the inpatient GTEUT group (10.29%), although the difference was not statistically significant. Hospitalization expenses in the ambulatory GTEUT group were reduced by approximately 29% compared to the inpatient group, with a statistically significant difference (p < 0.001). The length of hospital stay was significantly shorter for ambulatory group, who were discharged within 24 h (1.01 ± 0.10 days) compared to the inpatient group (5.76 ± 1.64 days) (p < 0.001). Anxiety and depression levels were higher in the ambulatory GTEUT group compared to the inpatient group, with the difference being statistically significant.

CONCLUSION

Ambulatory GTEUT is a safe alternative to inpatient surgical methods. It offers the advantages of shorter hospital stays and improved economic benefits. However, the mental health of patients undergoing daytime surgeries requires further attention.