Our Summary

This research paper talks about a specific type of surgery known as ambulatory thyroidectomy. This is a kind of outpatient surgery where the patient does not have to stay in the hospital for a long time. But, before this surgery is suggested, the patient and their family must be fully informed about the procedure, its usual after-effects, and any potential complications.

The surgery should only be performed by an experienced surgeon and a well-trained medical team. The healthcare facility should have all the necessary resources and be ready to provide care around the clock in case of emergencies that may require the patient to be admitted again.

It is also necessary to have a follow-up call the day after the surgery to check on the patient’s condition. This approach can be used for a range of thyroid-related procedures and surgeries. However, if the patient needs a complete thyroidectomy (removal of the entire thyroid), the conditions must be carefully considered and the patient’s home should be near a healthcare facility that can handle any issues related to the surgery.

The paper also emphasizes the need for a well-planned clinical pathway, which includes detailed protocols for before, during, and after the surgery. For example, measures to prevent excessive bleeding, pain, vomiting, and high blood pressure. After the surgery, the patient should be monitored for at least six hours in outpatient care.

If outpatient treatment is not possible or recommended, the hospital stay after a thyroidectomy can be limited to 24 hours, unless there are complications or the patient needs a specific type of blood-thinning medication.

FAQs

  1. Who can propose an ambulatory thyroidectomy and what are the necessary conditions for it?
  2. What types of thyroid surgeries can be managed on an ambulatory basis?
  3. What should be included in the clinical pathway for an ambulatory thyroidectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about thyroidectomy is to ensure they have a reliable support system in place for the postoperative period. This could include having someone available to help with tasks, provide transportation to follow-up appointments, and offer emotional support during recovery. It is important for the patient to communicate any concerns or complications to their healthcare team promptly to ensure proper management and care.

Suitable For

Patients who are typically recommended for thyroidectomy include those with:

  1. Thyroid cancer
  2. Large goiters causing compression of nearby structures
  3. Hyperthyroidism that does not respond to other treatments
  4. Thyroid nodules that are causing symptoms or are suspicious for cancer
  5. Graves’ disease
  6. Recurrent thyroid nodules
  7. Thyroid nodules that are growing rapidly

It is important for patients to be informed about the procedure, potential complications, and postoperative effects before undergoing thyroidectomy. It is also important for the healthcare team to ensure proper pre-, peri-, and postoperative protocols are in place for successful ambulatory management of thyroidectomy patients.

Timeline

  • Preoperative: The patient will meet with the surgeon to discuss the procedure and potential risks and benefits. They may undergo preoperative testing and preparation, such as blood work and imaging studies.

  • Day of surgery: The patient will arrive at the healthcare facility and undergo the thyroidectomy procedure. The surgery typically takes a few hours, and the patient will then be monitored in the recovery area before being discharged.

  • Postoperative: The patient may experience some pain, swelling, and difficulty swallowing in the days following the surgery. They will need to take prescribed medications, follow any dietary restrictions, and attend follow-up appointments with the surgeon.

  • Follow-up: The patient will continue to be monitored by the surgeon to ensure proper healing and to address any complications that may arise. Thyroid hormone replacement therapy may be needed if the entire thyroid gland was removed. Long-term follow-up will be necessary to monitor thyroid function and overall health.

What to Ask Your Doctor

  1. What is the reason for recommending a thyroidectomy in my case?
  2. What are the potential risks and complications associated with a thyroidectomy?
  3. What are the expected outcomes and recovery time after a thyroidectomy?
  4. Will I need to take any medications or make any lifestyle changes after the surgery?
  5. How will my thyroid levels be monitored after the surgery?
  6. What is the experience of the surgeon in performing thyroidectomies, especially in an ambulatory setting?
  7. What type of anesthesia will be used during the surgery?
  8. Will I need any additional tests or evaluations before the surgery?
  9. How soon after the surgery should I follow up with you for a postoperative check-up?
  10. What should I do if I experience any complications or side effects after the surgery?

Reference

Authors: Christou N, Di Maria S, Mirallié E, Noullet S, Mathonnet M, Menegaux F. Journal: J Visc Surg. 2023 Jun;160(3S):S119-S126. doi: 10.1016/j.jviscsurg.2023.04.007. Epub 2023 May 19. PMID: 37211444