Is thyroid and parathyroid surgery safe?
Is it suitable for one-day surgery?

Česká verzia

Authors: J. Gatěk ; B. Dudešek; J. Duben
Authors place of work: Chirurgické oddělení nemocnice Atlas Zlín, Univerzita Tomáše Bati ve Zlíně primář: MUDr. J. Gatěk, Ph. D.
Published in the journal: Rozhl. Chir., 2014, roč. 93, č. 1, s. 21-27.
Category: Original articles

Summary

Introduction:
Thyroid and parathyroid surgery is regarded as a safe procedure with minimal complications, especially in high-volume centres. This fact increases the demand to perform thyroid surgery as an outpatient procedure or as a short-stay procedure in selected patients.

Material and methods:
From 1995 to 2012, 5346 patients underwent thyroid surgery in the surgical ward of the Atlas Hospital. In a retrospective study we focused on complications that have occurred since 2008 in 1943 patients, especially postoperative hematoma and recurrent nerve palsy, comparing their number with literary data

Results:
Postoperative hematoma was diagnosed and revised in 22 cases, that is, in 1.1%. Potentially life-threatening postoperative hematoma, however, occurred also as late as 24 hours after surgery. All these cases were evaluated as emergency situations requiring urgent surgical revision. Definitive unilateral recurrent nerve palsy was diagnosed 15 times, i.e. in 0.77% of patients with complications, and, out of 2633 cases of „nerve at risk”, in 0. 56%.

Death has occurred in only two patients since 1995. Both of them were elderly and had serious comorbidities. All the other complications were not acute and could also have been managed in an outpatient procedure.

Conclusion:
The number of postoperative complications in the surgical ward of the Atlas Hospital in Zlín in thyroid surgery was similar to literature data, including the time of their occurrence. Outpatient and short-stay hospital procedure can be performed only in a strictly selected group of the patients.

Key words:
thyroid surgery – complications – one-day surgery

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