The type and extent of surgery may dictate the appropriateness of outpatient thyroidectomy. Unilateral thyroid lobectomy carries a lower probability of laryngeal dysfunction, considering the risk of unilateral versus bilateral vocal fold paralysis. Unilateral lobectomy is devoid of the risk of significant postoperative hypocalcemia compared with completion thyroidectomy or total thyroidectomy. Additionally, unilateral lobectomy has a smaller operative field than a total thyroidectomy, and therefore the potential risk per operation of a compromising postoperative hemorrhage may be reduced (13). However, same-day discharge of patients undergoing total thyroidectomy has been shown to be safe (9).
Surgery for thyroid cancer may require an intraoperative decision to perform a central neck dissection that could further increase the risk of postoperative hypoparathyroidism and/or laryngeal nerve dysfunction as well as lymphatic leak, and may favor inpatient observation or at least the flexibility to convert from an outpatient to an inpatient stay as deemed necessary for patient safety. The risk of postoperative bleeding increases with increasing thyroid gland weight and size of a dominant nodule (28), which could influence the decision for overnight hospital admission.
The type and extent of surgery may dictate the appropriateness of outpatient thyroidectomy. Unilateral thyroid lobectomy carries a lower probability of laryngeal dysfunction, considering the risk of unilateral versus bilateral vocal fold paralysis. Unilateral lobectomy is devoid of the risk of significant postoperative hypocalcemia compared with completion thyroidectomy or total thyroidectomy. Additionally, unilateral lobectomy has a smaller operative field than a total thyroidectomy, and therefore the potential risk per operation of a compromising postoperative hemorrhage may be reduced (13). However, same-day discharge of patients undergoing total thyroidectomy has been shown to be safe (9).Surgery for thyroid cancer may require an intraoperative decision to perform a central neck dissection that could further increase the risk of postoperative hypoparathyroidism and/or laryngeal nerve dysfunction as well as lymphatic leak, and may favor inpatient observation or at least the flexibility to convert from an outpatient to an inpatient stay as deemed necessary for patient safety. The risk of postoperative bleeding increases with increasing thyroid gland weight and size of a dominant nodule (28), which could influence the decision for overnight hospital admission.
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