‘Daycase parathyroidectomy: Time to change the norm?’ (2020)

Type of publication:
Conference abstract

Author(s):
Chang J.; Neophytou C.; Howard E.; Houghton A.

Citation:
British Journal of Surgery; 2020; vol. 107 ; p. 37

Abstract:
Introduction: The most recent BAETs audit report of 2017 shows a surprisingly low rate of same-day discharge following parathyroidectomy (10%). In our unit we have developed a simple and safe protocol which allows same day discharge for almost all patients (95%). The 2017 BAETS report has 11,463 patients recorded for primary hyperparathyroidism. Following this simple protocol could save over 9,500 inpatient bed days.
Method(s): Demographics, histology, biochemistry and length of stay were identified for all patients undergoing parathyroidectomy for primary hyperparathyroidism between 01/01/2010 and 31/12/2019. Following surgery all patients were discharged on Calcichew D3 one tablet tds, with arrangements for serum calcium analysis and outpatient appointment at 7 and 10 days Results: We performed 264 parathyroid procedures during the study period. The cohort had a median age of 63 (range 15 – 90). Day-case procedures were carried out in 95% (n=249). 10 patients stayed 24 hours, 4 for 48 hours and 1 patient for 4 days (urgent parathyroidectomy following acute medical admission with symptomatic hypercalcaemia). 1 patient was admitted overnight for observation of bleeding wound (no return to theatre). The remainder were admitted for a mixture of social and anaesthetic reasons. 6 patients (2%) had 30 day morbidity: 2with symptoms of relative hypocalcaemia (not admitted), 1 patient with hypocalcaemia requiring intravenous calcium, 1 seroma, 1 patient presented with an exacerbation of COPD and 1 haematoma.
Conclusion(s): We have shown that same-day discharge after parathyroid surgery is safe and ought to become the norm in other units.

Link to full-text [no password required]