Merck

Thyroid surgery as a 23-hour stay procedure.

Annals of the Royal College of Surgeons of England (2014-05-02)
A H Perera, S D Patel, N W Law
ABSTRACT

The main barriers to short stay thyroidectomy are haemorrhage, bilateral recurrent laryngeal nerve palsy causing respiratory compromise and hypocalcaemia. This study assessed the safety and effectiveness of thyroidectomy as a 23-hour stay procedure. All patients undergoing total or completion thyroidectomy were prescribed calcium and vitamin D3 supplements following surgery. Retrospective analysis identified patients admitted for longer than 23 hours and any readmissions. A total of 164 patients were admitted for 23-hour stay thyroid surgery over a 25-month period between 2008 and 2010. Four patients (2%) required admission for longer than 23 hours. No patients required emergency intervention for postoperative haemorrhage or airway compromise. Biochemical hypocalcaemia (despite calcium supplements) was detected in one patient when measured at the outpatient clinic two weeks following surgery. Twelve patients (7.3%) attended the accident and emergency department following discharge; four required admission for intravenous antibiotics for wound infection and one for biochemical hypocalcaemia. This single centre UK experience demonstrates that thyroidectomy can be carried out both safely and effectively as a 23-hour stay procedure. Prophylactic prescription of calcium and vitamin D3 reduces hypocalcaemia, and thereby also prolonged admission and readmission due to hypocalcaemia. Supplements are an acceptable, cost effective method of reducing hypocalcaemia and shortening postoperative length of stay.

MATERIALS
Product Number
Brand
Product Description

Supelco
胆钙化醇, Pharmaceutical Secondary Standard; Certified Reference Material
Sigma-Aldrich
胆钙化醇, ≥98% (HPLC)
胆钙化醇, European Pharmacopoeia (EP) Reference Standard
Sigma-Aldrich
钙, granular, 99%
Supelco
胆钙化固醇(维生素 D3), analytical standard
胆钙化醇, European Pharmacopoeia (EP) Reference Standard
Supelco
维生素D3标准液 CRM 溶液, 1 mg/mL in ethanol, ampule of 1 mL, certified reference material, Cerilliant®
USP
胆钙化醇, United States Pharmacopeia (USP) Reference Standard
Sigma-Aldrich
胆钙化醇, meets USP testing specifications
Sigma-Aldrich
钙, dendritic pieces, purified by distillation, 99.99% trace metals basis
Sigma-Aldrich
胆钙化醇, analytical standard
Sigma-Aldrich
钙, pieces, <1 cm, 99%
Sigma-Aldrich
钙, turnings, 99% trace metals basis
Sigma-Aldrich
钙, dendritic pieces, purified by distillation, 99.9% trace metals basis
Sigma-Aldrich
钙, dendritic pieces, purified by distillation, 99.5% trace metals basis